Gastric Bypass Surgery

For people with serious obesity and related health problems, gastric bypass surgery (also called Roux-en-Y) may be an option. It is one of the most common types of bariatric surgery.

It works by creating a small stomach pouch. This is connected directly to part of the small intestine, which forms a “Y” shape.

How It Works

A gastric bypass is a weight-loss surgery that reduces the size of your stomach and changes your small intestine. This procedure, called Roux-en-Y gastric bypass, is one of the most common operations for treating obesity.

First, your surgeon divides your stomach into a pouch that is about the size of an egg. This small pouch is separated from the rest of your stomach using surgical staples.

Then, your surgeon connects this new pouch to a lower section of your small intestine. This portion of your small intestine forms a “Y” shape with the pouch and is referred to as the Roux limb.

The pouch allows food to flow directly from the upper part of your stomach into the lower part of your small intestine without traveling through the rest of your stomach and duodenum. This means that your body absorbs fewer calories from food and you feel full faster.

Benefits

A gastric bypass procedure can help severely obese people lose significant amounts of weight. It also helps people who suffer from adult-onset diabetes and reflux (the back up of stomach acid and bile in the throat).

The surgery is performed by making small incisions around the upper part of the stomach. The surgeon then creates a smaller stomach pouch that can hold less than an ounce of food.

Next, the surgeon attaches this pouch to a section of the small intestine. Then, the food is rerouted to the lower part of the small intestine, bypassing most of the stomach and the first portion of the small intestine.

Patients who undergo gastric bypass lose a large amount of weight quickly. This rapid weight loss may cause gallstones to form in the bile ducts. If these stones travel to the liver, they may become dangerous or even cause liver damage.

Complications

A major complication of bypass surgery is leakage from the connection between your new stomach pouch and your small intestine. This can lead to pain, fever, infection and even death.

Internal hernias are another complication of bypass gastric surgery. They can occur in up to 30% of patients, especially in those who are overweight and have had prior intestinal surgery or illness.

Usually, this happens after open Roux-en-Y gastric bypass, although it can also occur in some laparoscopic patients. Occasionally, these hernias cause obstruction of the bowel.

Marginal ulcers develop in 3%-13% of patients after gastric bypass (27,28). They are usually a discrete collection of solitary ulcers at the gastrojejunal anastomosis or at a discrete distance from the anastomosis.

Distal band slippage occurs in 4%-13% of patients, and can occur posteriorly or anteriorly. Both forms of slippage involve upward herniation of the stomach tissue through the band.

Recovery

After bypass surgery, you may experience several side effects. They include fatigue, nausea, loss of appetite, and pain. These can affect your overall recovery.

Your healthcare team will monitor your progress closely to help you recover and feel better. They can also offer tips and recommendations on how to best manage these symptoms.

Gastric bypass surgery is a weight loss procedure that combines malabsorption and restriction techniques to help you lose weight. You’ll need to follow a strict diet for the first few months after surgery, which can be challenging.

You’ll begin by eating liquids for two to three weeks, then switch to a pureed diet, and finally move on to soft foods. Our registered dietitians will provide you with a step-by-step plan for your post-operative diet.

It’s important to eat slowly and chew your food thoroughly, to help prevent dumping syndrome, which occurs when your intestines don’t properly digest your new stomach pouch. This can lead to diarrhea, shakes and sweating.

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