Roux-en-Y Gastric Bypass
(Open or Laparoscopic)
The Roux-en-Y Gastric Bypass is the most commonly performed weight loss surgery in the United States. It involves the complete partition of the stomach, creating small pouch, which is connected to the small bowel through a tiny orifice. All of the stomach and about 2-3 feet of the intestines is completely bypassed (see diagram).
The Roux-en-Y Gastric Bypass is a restrictive and malabsorptive procedure. Recently, studies have shown that bypassing the stomach produces biochemical changes by which more fat is burned, the appetite is suppressed, and there is an increase in the basal metabolic rate.
This operation is a very effective procedure. Also, solid food is better tolerated than the purely restrictive procedures, and vomiting and nausea are uncommon. Thus, Roux-en-Y patients have a better quality of life compared to those with purely restrictive procedures. Sometimes, a condition known as "Dumping Syndrome" can occur as a result of eating too much sugar or foods with a high carbohydrate content. Symptoms include nausea, sweating, and diarrhea.
The Roux-en-Y can be done open or laparoscopically. In my practice, all procedures are done laparoscopically, and only in exceptional circumstances or in emergency procedures is a surgery done open. The lap RNY takes about 75-90 minutes operating time and requires a 48 hour hospital stay. The lap RNY is reversible; in other words, it can be undone, but it will take a very complex and drastic procedure.
Lap Roux-en-Y patients must come for the scheduled follow-up visits at 2 and 6 weeks, at 3, 6, 9 months, and at 1 year. Blood tests will help your doctor to measure patient progress.