Roux-en-Y Gastric Bypass

The operation creates a very small upper stomach pouch (less than one ounce) by transecting (dividing) the stomach.

Ingested food passes out of the upper pouch through a small opening into the small intestine. Most of the stomach and the first part of the small intestine are bypassed by the food. Thus, the operation is termed a "gastric bypass with Roux-en-Y gastrojejunostomy."

The major objective is to exclude most of the stomach. The point where the bile and pancreatic secretions are returned to mix with the ingested food is placed several feet downstream from the stomach. The gallbladder may be removed during the operation if it is found to be diseased.

The operation is usually done with laparoscopic instruments through several small incisions. The laparoscopic (minimally invasive) technique involves inserting a video telescope into the abdomen through a 12 mm incision. Five additional incisions (one 12 mm and four 5 mm) are placed in the upper abdomen. The operation is then carried out using specialized instruments. The laparoscopic approach has the potential advantages of smaller incisions, less pain, quicker recovery, fewer wound complications, earlier discharge from the hospital and less scarring while potentially providing the same weight reduction as the traditional open approach.

Frequently Asked Questions

Q: How will gastric bypass help me lose weight?
A: Gastric bypass will reduce the size of your stomach so you do not eat as much AND will bypass part of your small intestine so you absorb less calories.

Q: How long will I be in the hospital?
A: The typical hospital stay is two days after surgery.

Q: Can I exercise or go back to work?
A: We will ask you to walk when you get home, but check with your surgeon about exercise programs, driving or going back to work.

Q: Will I need to follow a special diet?
A: In the months before surgery, we will ask you to try to eat healthier foods to lose weight and be in better shape for your surgery.

Before your surgery, you will follow a modified liquid diet that will help to shrink the size of your liver. This helps the surgeon do your surgery safely.

In the hospital right after surgery and when you go home your diet will be liquids only. You will slowly begin to take other foods until you are eating many types of food. This may take up to seven weeks.

Advice to follow:

• Eat a high-protein, low-fat diet.
• Eat small portions.
• Eliminate sugar and sweets, carbonated drinks and alcohol.

Q: How often will I see the doctor after surgery?
A: You will have an appointment about two weeks after surgery and then routine visits through the first year after surgery. After this time it is very important to see your surgeon every year.

Q: How much weight can I expect to lose?
A: Most people lose 50% to 70% of their excess body weight in the first 12 to 18 months after surgery. Long-term success depends on commitment to diet and lifestyle changes. Remember - surgery is not a quick fix. It is a tool to help you with your weight loss.

Q: Do I need vitamins or supplements?
A: You may need to take vitamin supplements before and initially after surgery, then long-term as needed.

Each person is different but you must take:

• Multivitamins
• Calcium
• B-12

You will need extra liquid protein until you can eat enough food. The dietitian will discuss this with you.

Surgical Weight Loss Procedures Performed

Roux-en-Y Gastric Bypass

This procedure, often called gastric bypass, was developed in 1967. The operation creates a small upper-stomach pouch (less than one ounce) that limits food eaten and makes you feel full and satisfied with only a small amount. Also, not all food is digested because part of the small intestine is bypassed. This decreases the amount of calories that are absorbed. 

Sleeve Gastrectomy

Sleeve gastrectomy is a restrictive bariatric surgery. During this procedure, the surgeon creates a small, sleeve-shaped stomach. This limits the amount of food that can be eaten, yet makes you feel full and satisfied. The intestines are not bypassed in this procedure.

Adjustable Gastric Band

The adjustable gastric band (LAP-BAND®) is a device surgically applied to the upper part of the stomach to restrict the amount of food entering the stomach. A small port, placed under the skin in the abdomen, allows adjustment of the band's size. Frequent follow-up in the office is needed initially after this procedure. Follow-up care for a patient with an adjustable gastric band can be provided at all Surgical Weight Loss programs.

Orbera® Intragastric Balloon

A new option in weight-loss surgery, the Orbera® intragastric balloon, is inserted into the stomach and inflated so that it will restrict the amount you can eat and reduce hunger. The balloon is placed for six months, then removed. Our team works with you for a year after the balloon is placed to support your weight loss, diet, and exercise. 

Revisional Surgery

You may be a candidate for a revision of your original bariatric surgery if you're having physical problems. Revisions are performed on a case-by-case basis after a thorough work-up. Failure to lose weight or weight regain does not always require a revision. Our teams are committed to working with patients to lose weight and improve their quality of life. We offer a comprehensive approach to long-term weight management. All our programs accept transfer patients, too. If you are from another program or new to the area, just call one of our offices to discuss a possible transfer in care. 

Endoscopic ultrasound-Directed transgastric ERCP (EDGE)

EDGE is a minimally invasive procedure for gastric bypass patients with biliary, pancreatic, and gall bladder issues. Gall stones are a common problem for bypass patients and this procedure enables access to the stomach without open surgery, using ultrasound to help guide the placement of a stent. It provides a safe and proven alternative to traditional surgery and significantly reduces in-patient stays. Patients can continue toward their fitness goals without additional recovery time.