Laparoscopic Roux-en-Y Gastric Bypass

Understanding Gastric Bypass Surgery

Laparoscopic Roux-en-Y Gastric Bypass, also known as Gastric Bypass or RNY, is a weight loss surgery in which the majority of the stomach is bypassed and a small pouch is created. The RNY is the most common laparoscopic weight loss surgery performed in the US. The technique is less invasive than traditional open surgery and typically involves a quicker recovery time.

Wellstar Medical Group bariatric surgeons helped pioneer laparoscopic weight-loss procedures and perform hundreds of these procedures each year.

RNY achieves weight loss in all weight ranges with a solid long-term record of safety. Weight loss on average is in the range of 70-75% of excess body weight. With continued program follow-up, the loss is fairly well sustained over time.

Bariatric surgery is an option for morbidly obese individuals who have not been successful with other weight loss methods. Your Wellstar physician will discuss the options to determine if the RNY is a good choice for you. Considerations include your body mass index and related medical conditions such as diabetes, high blood pressure, sleep apnea and/or disabling osteoarthritis.

A number of complications are possible. Vitamin deficiencies are usually corrected with supplements. Another surgical complication is dumping, which can occur when rich, sugary foods move quickly through the stomach into the small intestine. Symptoms can include nausea, diarrhea, sweating and fainting. Your physician will discuss these and other possible issues to make sure that you fully understand the procedure and possible complications.

Before the procedure

• Stop smoking and begin eating five-to-six small meals per day.
• Consider joining a Wellstar support group.
• Your medical history will be reviewed. Medical tests may include a urinalysis, glucose test for diabetes, thyroid analysis, chest x-ray, electrocardiogram and psychiatric evaluation. You may also have an upper GI or upper endoscopy test, lung function test and a gall bladder ultrasound.
• Your doctor will talk with you about other relevant medical issues.
• Begin an exercise program to increase your fitness and stamina.
• You will receive counseling on nutrition and fitness to help you modify your habits and maximize post-surgery results.
• Tell your doctor about all medications or supplements you take. You may need to discontinue those that can increase bleeding.

During the procedure

• You will be given an anesthetic to put you to sleep during the surgery.
• Your Wellstar surgeon will make 4-6 small incisions in your belly. A tiny video camera (laparoscope) and thin surgical instruments will be inserted through the incisions.
• While viewing your belly on a video screen, the surgeon will create a small pouch at the top of the stomach, thus reducing the stomach’s size.
• The middle portion of the small intestine, called the jejunum, is attached to the new small pouch, bypassing the rest of the stomach and the upper part of the large intestine. The bypass permits food to be rerouted through the small intestine. Weight loss occurs because the pouch is small and because the body absorbs fewer calories due to the bypass.
• The procedure takes about 1.5 to 2 hours, depending on a patient’s previous operations.

After the procedure

• You will be monitored in a recovery room for an appropriate time before being moved to a hospital room.
• You will remain in the hospital for 2–3 nights and will be able to return to work and normal activities after about two weeks.
• A nurse or therapist will help you get up and walk soon after your surgery to keep your blood moving and improve healing.
• You may have a catheter in your bladder to remove urine.
• You may require supplemental oxygen for a day or two.
• You will wear special stockings that help prevent blood clots.
• You may take pain medication as needed.
• You will not be able to eat immediately after surgery, but will soon be able to have liquids, then pureed and soft foods. You will find that you become full after a small meal.
• The RNY is not a quick fix for weight loss. Your doctor will talk with you about ongoing diet and exercise, which are essential for long-term success.
• You will see your Wellstar bariatric surgeon regularly to monitor your progress and address any possible complications. Blood work will be very important at certain intervals to make sure your nutritional health remains intact.
• You’ll need to take extra vitamins and supplements to stay healthy.