Roux-En-Y Gastric Bypass was the first surgical weight loss procedure performed worldwide. This procedure restricts both the amount of food that can be consumed at one time as well as the amount of calories absorbed by the body (element of malabsorption). It is a major operation and is associated with the fastest weight loss. As with any weight loss procedure, it does take commitment and major lifestyle changes.

gastric bypass procedure - left: duodenum, jejunum; right: gastric pouch, bypassed portion of stomach, jejunum, bypassed duodenum

With Roux-En-Y Gastric Bypass, a small pouch is created from the upper portion of the stomach (approximately 30 ml/2 tablespoons). The small intestine is divided at its upper end and a portion is joined to the pouch. Food enters the pouch and travels directly to the small intestine, therefore bypassing the rest of the stomach – hence the name gastric bypass. Because food travels so quickly into the small intestine many hormones are released, which gives you the sensation of fullness. It has also been demonstrated that your metabolic rate increases, therefore increasing your weight loss.

The window for the maximum weight loss is around the 15 – 18 month mark which is referred to as the “window of opportunity”. This varies from individual to individual. On average, more than half of the patients lose 70% or more of their extra weight and then start to maintain. Long term success is dependent on accepting new lifestyle related to food selection, eating and activity.

Advantages and disadvantages of Roux-En-Y Gastric Bypass

Advantage of Roux-En-Y Gastric Bypass

  • Profound effect on reducing appetite due to hormonal changes
  • Associated with rapid weight loss
  • The metabolic changes may resolve health conditions including but not limited to:
    • Diabetes
    • Sleep Apnea
    • Hypertension
  • Can be done laparoscopically in patients weighing over 500 pounds, thereby providing all the advantages of minimally invasive surgery; fewer wound and lung problems, less pain and faster recovery.

Disadvantages of Roux-En-Y Gastric Bypass

  • Because a large portion of the stomach is bypassed, patients may have a problem absorbing vitamins and calcium. To avoid this risk, we place patients on daily multivitamins high in vitamin B-12, iron and calcium.
  • Over time, enlarging of the small stomach pouch may occur. This complication typically is due to over eating and stretching of the stomach. Symptoms may include poor weight loss and heartburn.
  • Dumping syndrome occurs when food passes rapidly from the stomach into the small intestine. This phenomena is usually caused by eating sweet or sugary foods. Early dumping occurs a few minutes to 45 minutes after eating. Symptoms may be mild to severe and can include: weakness and fainting, sweating, irregular and rapid heartbeat, low blood pressure, nausea and vomiting and diarrhea and cramps.
  • Leak can occur at the joint between the stomach and the small intestine and at the joint between the small intestine and the joint itself.
  • The lower stomach pouch and segments of the small intestine cannot be easily visualized if problems such as ulcers, bleeding or malignancy should occur.