Roux-en-Y Gastric Bypass—Laparoscopic Surgery
(Bariatric Surgery; Weight-Reduction Surgery)
- Restricting food intake—creates a small pouch to serve as the stomach, so you cannot eat as much
- Making the body unable to absorb as many calories from the food—bypasses the first part of the small intestine, where many of the calories from food are usually absorbed
|Roux-en-Y Gastric Bypass|
|Copyright © Nucleus Medical Media, Inc.|
Reasons for Procedure
- BMI greater than 40
- BMI 35-39.9 and a life-threatening condition, such as heart disease or diabetes
- BMI 35-39.9 with severe physical limitations that affect employment, mobility, and family life
- Long-term weight reduction
- Improvement in many obesity-related conditions (eg, glucose intolerance, diabetes , sleep apnea, high blood pressure , and high cholesterol )
- Improved mobility and stamina
- Enhanced mood, self-esteem, and quality of life
- Reduced risk of dying from cardiovascular disease (eg, heart attack , stroke ) and other causes
- Nutritional deficiencies—You will need to take vitamins to get adequate amounts of vitamin B12 , iron , and calcium .
- Blood clots
- Hernia formation
- Bowel obstruction
- Breakdown of the staples, allowing leakage of stomach juices into the abdomen
- Diarrhea, abdominal cramping, and vomiting
- Dumping syndrome—This occurs after eating sweets, when food moves too quickly through the small intestine causing sweating, fatigue, lightheadedness, cramping, and diarrhea .
- Complications of general anesthesia
- Death—This occurs in less than 1% of patients.
- Recent or chronic illness (eg, kidney disease)
- Old age
- Heart or lung disease
- Bleeding or clotting disorders
What to Expect
Prior to Procedure
- Thorough physical exam and review of medical history
- Attempts to lose weight (about 10%) through medically approved dietary means
- Ongoing consultations with a registered dietitian
- Mental health evaluation and counseling
Talk to your doctor about your medicines, herbs, and dietary supplements. You may be asked to stop taking some medicines up to one week before the procedure, like:
- Aspirin or other anti-inflammatory drugs
- Blood thinners, such as warfarin (Coumadin)
- Clopidogrel (Plavix)
- Do not start taking any new medicines, herbs, or supplements without talking to your doctor.
- Arrange for a ride to and from the hospital.
- Arrange for help at home as you recover.
- You might take antibiotics before coming to the hospital.
- You might take laxatives and/or an enema to clear your intestines.
- The night before your surgery, eat a light meal. Do not eat or drink anything after midnight unless told otherwise by your doctor.
- Shower or bathe the morning of your surgery.
Description of Procedure
|Roux-en-Y Gastric Bypass|
|Copyright © Nucleus Medical Media, Inc.|
How Long Will It Take?
How Much Will It Hurt?
Average Hospital Stay
- Pain medicine will be given as needed.
- On the day of surgery—You will not be given food or drinks.
On the day after surgery—You will have an
to check for leaks from the stomach pouch. For this test, you will drink a special liquid while x-rays are taken.
- If the upper GI x-ray is normal, you will be given 30 milliliters (mL) of liquids every 20 minutes.
- If leaks are found, you will receive nutrition through an IV until the leaks are fixed.
- On the second day after surgery—You will take 1-2 tablespoons of pureed food or 1-2 ounces of liquids every 20 minutes.
- Use an incentive spirometer to help you take deep breaths. This helps prevent lung problems.
- Wear elastic surgical stockings or boots to promote blood flow in your legs.
- Get up and walk in the hall daily.
- Ask your doctor about when it is safe to shower, bathe, or soak in water.
- You may be out of work for 2-6 weeks after gastric bypass surgery.
- Do not drive or lift anything heavy until your doctor tells you it is safe. This may be up two weeks or more.
- Walk as soon as possible, with a goal of exercising daily.
- You may have emotional ups and downs after this surgery.
- You will meet regularly with your healthcare team for monitoring and support.
- You will begin with 4-6 meals per day. A meal is two ounces of food.
- For the first 4-6 weeks after surgery, all food must be pureed.
- Once you move to solid foods, they must be chewed well.
- When making food choices, you will need to consume enough protein.
- Avoid sweets and fatty foods.
- Eating too much or too quickly can cause vomiting or intense pain under your breastbone. Most people quickly learn how much food they can eat.
- Pain medicines
- Vitamin and mineral supplements
Call Your Doctor
- Signs of infection, including fever and chills
- Redness, swelling, increasing pain, excessive bleeding, or discharge from the incision site
- Cough , shortness of breath, chest pain, or severe nausea or vomiting
- Worsening abdominal pain
- Blood in the stool
- Pain, burning, urgency or frequency of urination, or persistent bleeding in the urine
- Persistent nausea and/or vomiting
- Pain and/or swelling in your feet, calves, or legs; sudden shortness of breath or chest pain
- Any other worrisome symptoms
American Society for Metabolic and Bariatric Surgery https://www.breastsurgeons.org/
National Institutes of Health http://health.nih.gov/
Weight Control Information Network http://www.win.niddk.nih.gov/
BC Health Guide, British Columbia Ministry of Health http://www.bchealthguide.org/
Canadian Laparoscopic Weight Loss Surgery http://www.weightlosssurgery.ca/
Gastrointestinal surgery for severe obesity. National Institute of Diabetes and Digestive and Kidney Diseases website. Available at: http://win.niddk.nih.gov/publications/gastric.htm . Accessed June 18, 2008.
Laparoscopic gastric bypass procedure. Cleveland Clinic website. Available at: http://www.clevelandclinic.org/health/health-info/docs/1900/1993.asp?index=4355 . Accessed June 18, 2005.
Laparoscopic Roux-en-Y. Baylor College of Medicine website. Available at: http://www.debakeydepartmentofsurgery.org . Accessed June 18, 2005.
Obesity risks add to complications of gastric bypass [news release]. Duke University Medical Center website. Available at: http://www.dukemednews.org/news/article.php?id=7217 . Accessed June 20, 2005.
Obesity surgery. Columbia University website. Available at: http://www.columbiasurgery.org/divisions/obesity/index%5Fobe.html . Accessed June 20, 2005.
Obesity surgery. Ohio State University website. Available at: http://surgery.osu.edu/generals/obesity.cfm . Accessed June 20, 2005.
Rationale for the surgical treatment of morbid obesity. American Society for Bariatric Surgery website. Available at: http://www.asbs.org/html/rationale/rationale.html . Accessed June 17, 2005.
Surgery for obesity: what is it and is it for you? Mayo Foundation for Medical Education and Research website.Available at: http://www.mayoclinic.com/invoke.cfm?id=HQ01465 . Accessed June 18, 2005.
9/2/2009 DynaMed Systematic Literature Surveillance DynaMed's Systematic Literature Surveillance : The Longitudinal Assessment of Bariatric Surgery (LABS) Consortium. Perioperative safety in the longitudinal assessment of bariatric surgery. N Engl J Med . 2009;361:445-454.
6/24/2011 DynaMed's Systematic Literature Surveillance DynaMed's Systematic Literature Surveillance : Pontiroli AE, Morabito A. Long-term prevention of mortality in morbid obesity through bariatric surgery. a systematic review and meta-analysis of trials performed with gastric banding and gastric bypass. Ann Surg. 2011;253(3):484-487. Maciejewski ML, Livingston EH, Smith VA, et al. Survival among high-risk patients after bariatric surgery. JAMA. 2011;305(23):2419-2426.
- Reviewer: Marcin Chwistek, MD
- Review Date: 11/2012 -
- Update Date: 11/30/2012 -