Roux-en-Y Gastric Bypass

Gastric bypass was first performed in 1967, and was the most common weight loss procedure performed in the United States until 2009, when it was overtaken by Adjustable Gastric Banding (LapBand® andREALIZE™ Band). Bypass procedures are also declining since 2009 since the same rapid weight loss and improvement in co-morbidities (including diabetes) can be achieved with the safer sleeve.

The laparoscopic Roux-en-Y gastric bypass procedure involves making several small incisions through which the surgeon inserts laparoscopic instruments to perform the surgery. The procedure is designed to make a small reservoir (pouch) for food at the upper end of your stomach. This pouch is connected to the upper small intestine by a new small anastomosis (outlet or stoma). The ingested food thereby bypasses the majority of your stomach, which remains alive and undisturbed, but functional otherwise. In other words, the majority of your stomach does not have food passing through. Like the sleeve, it is associated with about a 6 month period of decreased appetite.

The nature and purpose of this operation is to functionally limit the amount of food or liquid intake at any given time. There is a small component of malabsorption, at least initially. Like the sleeve, this procedure is often associated with fairly rapid weight loss initially, which stabilizes over time to a weight that is healthy for you.

Advantages of the Laparoscopic Roux-en-Y Gastric Bypass:

  • Weight loss averages 60 –70% excess body weight within one year after surgery
  • Proven long term effectiveness – studies show that after 10 – 14 years, patients still maintain 50 – 60 % excess body weight loss.
  • Studies show that 90% of obesity-related medical problems such as hypertension, sleep apnea, heartburn (gastroesophageal reflux disease/GERD), adult-onset diabetes, cardiac function, and depression to name a few, improve or are completely resolved.

Disadvantages/Risks of the Roux-en-Y Gastric Bypass:

  • Gastric Sleeve has the same benefits with lower short- and long-term risks.
  • By its nature – cutting the stomach and intestines and re-routing – gastric bypass carries the highest surgical risk of the procedures offered by BBSA.
  • By its nature, the intestines have been re-routed and there is a small risk of bowel obstruction.
  • Potential for protein, vitamin, and mineral deficiency in non-compliant patients .
  • “Dumping” – a symptom complex that can involve sweating, flushing, diarrhea, nausea, or vomiting, pain that occurs after eating foods high in fat or sugar content.
  • Stretching of the stomach pouch or outlet over time secondary to overeating.
  • Difficult to revise or reverse.
  • Decreased imaging capabilities of the bypassed stomach, duodenum, and segments of the small bowel.
  • Not offered to smokers as there is a very high risk of pouch ulcers which can lead to very serious and potentially fatal consequences.
  • Inability to take Aspirin, anti-inflammatories, or steroids for life as these also increase the risk of developing pouch ulcers.
  • Life-long requirement to take specialized vitamins and supplements, possibly shots.
  • Permanent and possibly fatal vitamin deficiency issues if non-compliant with recommendations.
  • Life-long requirement to have specialized labs checked periodically.
  • Strictures (narrowing) of the outlet requiring Endoscopic dilatation.

Please contact us call us at 859.543.1577 to learn more about how Bluegrass Bariatrics can help you and/or your loved ones, today.

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