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:
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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:
If you are planning to have Roux-en-Y gastric bypass, your doctor will review a list of possible complications, which may include:
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:
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.
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.
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You will be taken to the recovery area for monitoring. You will also be given pain medication.
About 2 hours
Anesthesia will prevent pain during surgery. Pain and discomfort after the procedure can be managed with medications.
The usual length of stay is 2-5 days. Your doctor may choose to keep you longer if complications arise.
While you are recovering at the hospital, you may receive the following care:
While in the hospital, you may be asked to do the following:
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 if any of these occur:
If you think you have an emergency, call for emergency medical services right away.
American Society for Metabolic and Bariatric Surgery
Weight Control Information Network
Weight Loss Surgery
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. Updated June 2011. Accessed December 4, 2014.
Maciejewski ML, Livingston EH, et al. Survival among high-risk patients after bariatric surgery. JAMA. 2011;305(23):2419-2426.
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 December 4, 2014.
Roux-en-Y gastric bypass. Cleveland Clinic website. Available at: http://my.clevelandclinic.org/services/procedure_treatment/gastric_bypass_surgery/roux-en-y.aspx. Accessed December 4, 2014.
Roux-en-Y gastric bypass. Columbia University Medical Center website. Available at: http://obesitymd.org/gastric.html. Accessed December 4, 2014.
Roux-en-Y gastric bypass weight-loss surgery. Johns Hopkins Medicine website. Available at: http://www.hopkinsmedicine.org/healthlibrary/test_procedures/gastroenterology/roux-en-y_gastric_bypass_weight-loss_surgery_135,65/. Accessed December 4, 2014.
9/2/2009 DynaMed Systematic Literature Surveillance http://www.ebscohost.com/dynamed: 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 http://www.ebscohost.com/dynamed: 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.
1/2/2014 DynaMed's Systematic Literature Surveillance http://www.ebscohost.com/dynamed: Jensen M, Ryan D, et al. 2013 AHA/ACC/TOS Guideline for the management of overweight and obesity in adults: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines and The Obesity Society. Circulation. Nov 12 2013.
Last reviewed December 2014 by Michael Woods, MD Last Updated: 12/20/2014