Roux-en-Y Gastric Bypass
A Roux-en-Y gastric bypass is a weight loss procedure also known as a gastric bypass. It involves shrinking the size of your stomach and making some changes to the digestive tract. People often lose more weight with bypass surgery than sleeve gastrectomy however it is a slightly more complex surgery.
What is Roux-en-Y gastric bypass surgery?
A Roux-en-Y gastric bypass is surgery to help you lose weight.
A large proportion of calories and fat we eat is absorbed in the upper digestive tract. This includes the stomach and beginning of the small intestine.
A Roux-en-Y gastric bypass works in two ways: it reduces the size of your stomach, restricting the amount of food you can comfortably eat; and bypasses a section of small intestine, resulting in less food and nutrient absorption.
Benefits of Roux-en-Y gastric bypass for weight loss
Like other weight loss surgeries, a Roux-en-Y gastric bypass procedure is an effective tool to help you lose excess weight. Studies show that people tend to lose more weight after gastric bypass surgery than laparoscopic sleeve gastrectomy. That is between 60-80% of their excess body weight over the first 12-24months.
Maintaining a healthier weight reduces your risk of serious disease (including heart disease, type 2 diabetes and stroke) and the need for other medications. It can also help improve your sleep and boost your fertility.
Creating a smaller stomach and changing the digestive path has other benefits too:
Reducing the amount of ‘hunger hormone’ ghrelin produced by the stomach helps to reduce appetite. This means you generally want to eat less food.
Increasing production of GLP-1 hormone which stimulates the body to release insulin – making this procedure particularly helpful for people with type 2 diabetes.
Eating foods high in sugar and/or fat, particularly on an empty stomach, can make you feel sick due to something called ‘dumping syndrome’.
Dumping syndrome causes uncomfortable symptoms such as sweating, cramps, diarrhoea, nausea, dizziness and fatigue. People tend to avoid eating high calorie foods as a result.
Gastric bypass has also been shown to help reduce or resolve other conditions including gastro-oesophageal reflux disease (GORD).
Step by step: Roux-en-Y gastric bypass
Roux-en-Y gastric bypass procedure is performed using minimally invasive keyhole surgery under general anaesthetic.
Several small incisions are made in the abdomen for surgical instruments including a laparoscope (tiny camera).
Dr Hopkins will first create a small pouch from the upper part of the stomach and connect it further down the small intestine.
Food you eat will now enter a small pouch before entering the second part of the small intestine, bypassing between 90-95% of your stomach and the beginning of the small intestine.
The bypassed section of the stomach is connected further along the intestine so digestive juices can still work to aid digestion.
Roux-en-Y gastric bypass surgery usually takes between 1-3 hours to complete.
After surgery: what to expect
You should expect to be in hospital for 1-3 days for your Roux-en-Y gastric bypass procedure. Dr Hopkins will discuss your diet plan and make sure you have time to ask questions before and after your procedure.
You will begin a modified diet straight away, including fluids only for the first two weeks, followed by a pureed and soft food diet for up to six weeks. You will also need to take vitamin and mineral supplements after surgery, including a multivitamin with iron, calcium and vitamin B12.
Depending on your job, you can expect to return to work two weeks post-surgery, at full or reduced duties. As with any abdominal surgery, there is a risk of hernia at the site of any incisions. You should avoid heavy lifting and strenuous exercise. Walking is a good option as part of a long-term commitment to staying active and eating well.