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Roux-en-Y Gastric Bypass—Laparoscopic Surgery
(Bariatric Surgery; Weight-Reduction Surgery)
Pronounced: Roo-n-y gas-trick bye-pass
by Karen Kassel, MS, RD, MEd
Roux-en-Y gastric bypass is a surgery for obesity. It changes the size of the stomach and small intestine to cause weight loss by:
Reasons for Procedure TOP
The surgery treats severe obesity. A calculation called body mass index ( BMI) is used to determine how overweight or obese you are. A normal BMI is 18.5-25.
Roux-en-Y gastric bypass is a weight loss option for people with:
The success of gastric bypass surgery depends on your commitment to lifelong health habits. If lifestyle changes are made and maintained, the benefits of bariatric surgery include:
Possible Complications TOP
Problems from the procedure are rare, but all procedures have some risk. Your doctor will review potential problems, like:
Long-term complications include vomiting and gallstones.
Before your procedure, talk to your doctor about ways to manage factors that may increase your risk of complications such as:
What to Expect TOP
Prior to Procedure
Each bariatric surgery program has specific requirements. Your program will likely include the following:
Leading up to your procedure:
General anesthesia will be used. You will be asleep.
Description of Procedure TOP
To prepare you for surgery, an IV will be placed in your arm. You will receive fluids and medications through this line during the procedure. A breathing tube will be placed through your mouth and into your throat. This will help you breathe during surgery. You will also have a catheter placed in your bladder to drain urine.
Several small cuts will be made in the abdomen. Gas will be pumped in to inflate your abdomen. This will make it easier for the doctor to see. A laparoscope and surgical tools will be inserted through the incisions. A laparoscope is a thin, lighted tool with a tiny camera. It sends images of your abdominal cavity to a monitor in the operating room. Your doctor will operate while viewing the area on this monitor.
Surgical staples will be used to create a small pouch at the top of your stomach. This pouch, which can hold about 1 cup of food, will be your new, smaller stomach. A normal stomach can hold 4-6 cups of food.
Next, the small intestine will be cut and attached to the new pouch. With the intestinal bypass, food will now move from the new stomach pouch to the middle section of the small intestine. It will skip the lower stomach and the upper section of the small intestine.
Finally, the upper section of the small intestine will be attached to the middle section of the small intestine. This will allow fluid that the lower stomach makes to move down the upper section of the small intestine and into the middle section.
When the bypass is completed, the incisions will be closed with staples or stitches.
Be aware that in some cases, the doctor may need to switch to an open surgery. During an open surgery, a larger cut in the abdomen will be made to do the surgery.
After Procedure TOP
You will be taken to the recovery area for monitoring. You will also be given pain medication.
How Long Will It Take? TOP
About 2 hours
How Much Will It Hurt? TOP
Anesthesia will prevent pain during surgery. Pain and discomfort after the procedure can be managed with medications.
Average Hospital Stay TOP
The usual length of stay is 2-5 days. Your doctor may choose to keep you longer if complications arise.
Post-procedure Care TOP
At the Hospital
While you are recovering at the hospital, you may receive the following care:
During your stay, the hospital staff will take steps to reduce your chance of infection such as:
There are also steps you can take to reduce your chance of infection such as:
You will need to practice lifelong healthy eating and exercising habits. Keep in mind after your surgery:
Your new stomach is the size of a small egg. It is slow to empty, causing you to feel full quickly. Therefore, you need to eat very small amounts and eat very slowly:
Call Your Doctor TOP
Contact your doctor if your recovery is not progressing as expected or you develop complications such as:
If you think you have an emergency, call for emergency medical services right away.
American Society for Metabolic and Bariatric Surgery
National Institute of Diabetes and Digestive and Kidney Diseases
Weight Loss Surgery
Bariatric surgery. EBSCO DynaMed Plus website. Available at: http://www.dynamed.com/topics/dmp~AN~T483434/Bariatric-surgery. Updated October 23, 2017. Accessed December 21, 2017.
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Updated December 2016. Accessed December 22, 2017.
Bariatric surgery. National Institute of Diabetes and Digestive and Kidney Diseases website. Available at: https://www.niddk.nih.gov/health-information/weight-management/bariatric-surgery. Accessed December 21, 2017.
Maciejewski ML, Livingston EH, Smith VA, et al. Survival among high-risk patients after bariatric surgery. JAMA. 2011;305(23):2419-2426.
Obesity surgery: Roux-en-Y gastric bypass. Cleveland Clinic website. Available at: https://my.clevelandclinic.org/health/treatments/17285-obesity-surgery/roux-en-y-gastric-bypass. Accessed December 21, 2017.
Roux-en-Y gastric bypass. Columbia University Medical Center website. Available at:
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Accessed December 21, 2017.
Roux-en-Y gastric bypass weight-loss surgery. Johns Hopkins Medicine website. Available at: https://www.hopkinsmedicine.org/healthlibrary/test_procedures/gastroenterology/roux-en-y_gastric_bypass_weight-loss_surgery_135,65. Accessed December 21, 2017.
9/2/2009 DynaMed Plus Systematic Literature Surveillance http://www.dynamed.com/topics/dmp~AN~T483434/Bariatric-surgery: The Longitudinal Assessment of Bariatric Surgery (LABS) Consortium. Perioperative safety in the longitudinal assessment of bariatric surgery. N Engl J Med. 2009;361(5):445-454.
6/24/2011 DynaMed Plus Systematic Literature Surveillance http://www.dynamed.com/topics/dmp~AN~T483434/Bariatric-surgery: 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.
Last reviewed December 2017 by EBSCO Medical Review Board Marcin Chwistek, MD
Last Updated: 12/20/2014
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