Roux en Y Gastric Bypass
What Is A Roux en Y Gastric Bypass?
The Roux en Y Gastric Bypass has been performed worldwide for over 40 years and it is considered the gold standard of weight loss surgery. The gastric bypass has a restrictive and a malabsorptive component. For these reasons, weight loss can be more substantial than other less aggressive options.
In average patients that undergo a gastric bypass can experience 70-80% excess body weight loss. This weight loss is usually achieved between 12-18 months.
The first laparoscopic gastric bypass was performed in 1993 and since then the outcomes of this procedure have significantly improved. Because the operation is done using small incisions instead of a large midline incision the complication rate has decreased substantially. The patients will experience shorter hospital stay, less blood loss, decrease risk of infection, hernias, and pain. It is described in the literature that the overall complication rate for a gastric bypass is around 10-15 %, and the mortality rate is less than 2 percent nationwide.
If you need more information regarding the potential complications of bariatric surgery including the gastric bypass, please click on this link to read the blog post.
One of the big advantages of bariatric surgery including a Roux en Y Gastric Bypass is the resolution of comorbidities. Diabetes, sleep apnea, esophageal reflux, and high blood pressure can improve or resolve in upwards of 80 percent.
In the Spotlight
Advantages & Disadvantages
- Short hospital stay
- Excellent weight loss
- Low risk
- Resolution of comorbidities
- Long track record
- Significant anatomic changes
- Potential for leak
- Potential for narrowing
- Potential for ulcers
- Dumping syndrome
How Is The Gastric Bypass Done?
In Dr. Caban’s practice the Roux en Y gastric bypass is done laparoscopic or with five small incisions throughout the upper part of your abdomen. This approach allows the patients to recover faster and to have less pain after surgery.
Using a high definition camera, a monitor and special instruments Dr Caban navigate through the patient’s abdomen. The first step of the gastric bypass is the division of the small bowel with the creation of the Roux limb. This is usually the easiest and the quickest portion of the procedure.
The creation of the gastric pouch or the very small stomach is next. The new stomach is approximately 30 ml, which is similar to the size of a large chicken egg.
After the new stomach is created the Roux limb (small bowel) is attached with sutures and staples to the gastric pouch. This is one of the critical parts of the surgery. Once this connection is completed Dr. Caban will test the connection by performing an endoscopy. The endoscopy is very useful in identifying any leaks, bleeding or narrowing of the newly formed connection.
The entire procedure takes approximately 2-3 hours. The small incisions are then closed with absorbable sutures and skin glue. After waking up from general anesthesia the patient is taken to the recovery room.
Life After A Gastric Bypass
Most patients after surgery will be admitted to the hospital for two days. The day after surgery you will be started on sips of water. The second day you will be advanced to sips of protein drinks. After discharge, you will strictly follow the diet that was given to you prior to surgery during the preop class given by the bariatric coordinator. The diet progresses from liquids, to puree, soft food and eventually to regular food in a period of 6-8 weeks.
Vitamin replacement is essential after a gastric bypass. Vitamin B12, in particular, should be replaced for life. You should use either the nasal spray, sublingual drops/tablets or injections. Special formulas specific for bariatric patients can be found in many stores or online. You can try Bariatric Advantage, Bariatric Fusion or GMC.
After discharge, you should stay away from any heavy lifting or any excessive physical activities for 4-6 weeks. Most patients will return to work 2-4 weeks after surgery. The routine follow up with Dr. Angel Caban is 2 weeks after surgery followed by visits every 3 months for the first year.
Weight loss after a Gastric Bypass can be more pronounce and faster. This is due to the more aggressive nature of the procedure.
The first 3 months after surgery are crucial for your success. You will lose the majority of the weight in this period. It is imperative that you put great effort during the first quarter to lose as much weight as possible. Weight loss starts to taper down after the first 3 months and most patients will achieve maximum weight loss after surgery around 12-18 months.
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