Center for Weight Loss - Roux-en-Y Gastric Bypass

Roux-en-Y Gastric Bypass (RYGBP)

This procedure combines two approaches to surgical weight loss: reducing how much the stomach can hold and reducing how much the digestive track can absorb of the food that has been eaten. The Roux-en-Y gastric bypass is one of the most frequently done operations for morbid obesity in the United States.

In this procedure, a pouch is created in the stomach, as with other capacity reduction options. However, the stomach is completely stapled shut, and the outlet of the pouch opens into the intestine rather than into the rest of the stomach. This is done by dividing the small intestine just beyond the duodenum and bringing it up to the pouch to construct a connection. The open end of the intestine that is closest to the duodenum is sewn back into the side of the limb of the intestine that is attached to the pouch.

Average weight loss is higher using this approach because, in addition to restricting how much food can be eaten, the procedure limits how much food can be absorbed by the body.

One effect of this procedure is that the body can absorb less iron and calcium and may experience a steady reduction of vitamin B12 because food doesn't reach the stomach. This may cause various forms of anemia or metabolic bone disease in some patients. Iron, calcium and B12 should be replaced through diet and supplements. Other side effects include:
  • Dumping, which is when food passes too quickly from the stomach into the small intestine, causing nausea, weakness, sweating, faintness or sometimes diarrhea after eating. These reactions may be especially intense after eating sweets.
  • Pouch distention and staple-line disruption, which may result in less weight being lost
  • Difficulties in getting X-rays or endoscopic views of the bypassed portion of the stomach, duodenum and segment of the small intestine in the event of a problem, such as ulcers, bleeding or malignancy
Patients are usually able to leave the hospital two days after surgery, but this depends on your surgeon's recommendation about your specific case.

Patients are referred to a support group program. You should return to your surgeon for routine post-operative care about a week after you leave the hospital. Follow up visits with your surgeon typically are scheduled:

  • One or two visits per month for the first six months
  • One or two visits in the second six months
  • Annually thereafter

You can learn more about gastric banding and adjustments in the "For Patients" section, Gastric Bypass Surgery: What to Expect.

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