Roux-en-Y gastric bypass (RYGB) is a type of weight-loss surgery. Weight-loss surgery is also called bariatric surgery. It’s often done as a laparoscopic surgery, with small incisions in the abdomen.
This surgery reduces the size of your upper stomach to a small pouch about the size of an egg. The surgeon does this by stapling off the upper section of the stomach. This reduces the amount of food you can eat. The surgeon then attaches this pouch directly to part of the small intestine called the Roux limb. This forms a “Y” shape. The food you eat then bypasses the rest of the stomach and the upper part of your small intestine. This reduces the amount of fat and calories you absorb from the foods you eat. It also reduces the amount of vitamins and minerals you absorb from food.
Gastric bypass surgery is used to treat severe obesity. It’s advised for people who have tried other weight loss methods without long-term success. Your doctor may advise gastric bypass surgery if you are severely obese with a body mass index (BMI) over 40. Your doctor may also advise it if you have a BMI between 35 and 40 and a health condition such as sleep apnea, high blood pressure, heart disease, or type 2 diabetes.
Gastric bypass can help a person lose about 100 pounds of excess weight. It may also reverse type 2 diabetes and stop heartburn and reflux. Weight-loss surgery can also lower the risk for high blood pressure, sleep apnea, and certain heart problems.
Bleeding, infection, and blood clots in your legs are possible side effects that may occur after any surgery. General anesthesia may also cause breathing problems or other reactions. You may also have leaks from the stomach pouch or the Roux limb.
Possible problems over time may include:
Your healthcare team will need to make sure that gastric bypass surgery is a good option for you. Weight-loss surgery isn’t advised for people who abuse medicines or alcohol, or who are not able to commit to a lifelong change in diet and exercise habits.
Before having surgery, you’ll need to enroll in a bariatric surgery education program. This will help you prepare for surgery, and life after surgery. You’ll have nutritional counseling. And you may have a psychological evaluation. You’ll also need physical exams and tests. You will need blood tests. You may have imaging studies of your stomach, or have an upper endoscopy.
If you smoke, you will need to stop several months before surgery. Your surgeon may ask you to lose some weight before surgery. This will help make your liver smaller, and make surgery safer. You’ll need to stop taking aspirin, ibuprofen, and other blood-thinning medicines in the days before your surgery. You shouldn’t eat or drink anything after midnight before surgery.
You may stay in the hospital for 1 to 2 days after the surgery. Talk with your doctor about wound care, safe pain medicines, and when you can start physical activity. Your doctor will tell you how often to change the dressing on your incision.
Tell your doctor right away if you have any of the below:
You will likely only have liquids for the first 1 to 2 weeks after surgery. Your doctor may slowly add soft food and then regular food to your diet about a month after surgery. You will be need to chew slowly and fully, and not to drink 30 minutes before or after you eat.
Your initial weight-loss may occur quickly, so it's important to get all of the nutrition and vitamins you need as you recover. Your doctor will prescribe vitamin and mineral supplements that your body may no longer absorb well from food alone.
To prevent nutritional problems after gastric bypass surgery, many doctors advise:
Because nutritional deficiencies can happen after this surgery, experts recommend that your blood be tested at least every 6 months for the rest of your life to ensure that you are getting the right amount of vitamins and minerals.
During weight-loss, you may have body aches, dry skin, mood changes, and temporary hair thinning, and feel tired and cold. As your weight stabilizes, these problems should go away. Weight loss continues for about a year, and then will stop. After a year, you may be able to eat more if the pouch stretches. You should use the first year to develop good eating and exercise habits that will keep you from regaining weight.
Along with follow-up appointments with your doctor and surgeon, you will likely see a dietitian who will teach you how and what to eat with your reduced stomach size. You may also need to see a psychologist to help you deal with the feelings and concerns over your changed lifestyle.
Before you agree to the test or the procedure make sure you know:
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