Gastric Bypass

Roux-en-Y Surgical Procedure 

Roux-en-Y Gastric Bypass Surgery Animation View Animation Animation courtesy of Ethicon Endo-Surgery - A Johnson & Johnson Company

Roux-en-Y gastric bypass surgery is the most popular bariatric surgery in the United States and a procedure offered through the Mary Washington Hospital Weight Loss Surgery Program. This procedure sections off the top of the stomach to create an egg-sized pouch. A piece of the small intestine is connected to the pouch, which fills quickly with a small amount of food. A person feels full fast, and as a result, eats less. Food passes from the pouch directly through the small intestine, bypassing the rest of the stomach, which continues to produce digestive juices to help break down food in the small intestine. This new digestive route reduces the amount of calories the body absorbs, which promotes weight loss. 

Advantages of Roux-en-Y gastric bypass surgery 

• 83.7 percent of type 2 diabetes cases are resolved.
• Studies always include a control group; the control group that doesn’t have bariatric surgery is at a higher risk for type 2 diabetes: 3.7 times higher.
• Gastric bypass surgery successfully resolves more people’s type 2 diabetes than purely restrictive procedures.
• Resolution of type 2 diabetes often occurs within days of the surgery.
• 96.9 percent of hyperlipidemia cases are resolved.
• 75.4 percent of hypertension cases are resolved; 87.1 percent are resolved or improved.
• Substantial weight reduction occurs; 61.6 percent of excess weight is lost.
• In 2000, a study of 500 patients showed that 96 percent of co-morbidities (the study looked specifically at back pain, sleep apnea, high blood pressure, type 2 diabetes, and depression) were improved or resolved.
• The average excess weight loss after a gastric bypass procedure is generally higher than with a purely restrictive procedure.
• As with every type of bariatric surgery, the overall quality of life for patients improves greatly. A great deal of excess weight is lost, and patients experience resolution of co-morbidities, and improved appearance, social opportunities, and economic opportunities.
• A condition known as dumping syndrome can occur from eating too much sugar or large amounts of food. While it isn’t considered a serious health risk, the results can be very unpleasant. Symptoms can include vomiting, nausea, weakness, sweating, faintness, and, on occasion, diarrhea. Some patients are unable to eat sugary foods after surgery.

Risks and Disadvantages Roux-en-Y gastric bypass surgery

• Because the duodenum and other sections of the small intestine are bypassed, poor absorption of iron and calcium can cause low total body iron and a greater chance of having iron-deficiency anemia. Patients who experience chronic blood loss during excessive menstrual flow or bleeding hemorrhoids should be aware of the chance of iron-deficiency anemia. Women, already at risk for osteoporosis that can occur after menopause, should be aware of the possibility of increased bone calcium loss. By taking a multivitamin and calcium supplements, patients can maintain a healthy level of minerals and vitamins.
• Bypassing the duodenum can cause metabolic bone disease in some patients, resulting in bone pain, loss of height, humped back, and fractures of the ribs and hipbones. Eating foods rich in nutrients and taking vitamins can help patients avoid this.
• Chronic anemia due to vitamin B12 deficiency may occur. The problem usually can be managed with vitamin B12 pills or injections.
• The bypassed portion of the stomach, duodenum, and parts of the small intestine cannot be seen easily using X-ray or endoscopy if there are problems such as ulcers, bleeding, or malignancy.
• It is a permanent, nonreversible procedure.

Disclaimer: 
As with any surgery, there are specific risks and possible complications associated with this surgical procedure. If you have specific questions about this procedure we suggest you arrange for a consult with one of Weight Loss Surgery Physicians at Mary Washington Hospital.