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Gastric
Bypass
Surgery
Roux-en-Y
Gastric
Bypass
The
Roux-en-y
gastric
bypass
is
considered
the "gold
standard"
for
bariatric
surgery
techniques,
and is the
best-understood,
most-studied,
and
arguably
the most
effective
long-term
solution
to morbid
obesity.
Benefits
of the
surgery
include
two stages
of weight
loss
mechanisms,
restriction
(dramatic
reduction
in the
amount of
food you
can eat at
a given
time) and
malabsorption
(reduction
in your
body's
capability
to fully
absorb all
of what
you do
eat).
Patients
can expect
statistically
to lose
70-80% of
their
excess
body
weight
with full
aftercare
compliance,
and have
shown an
ability to
maintain
that loss
15 years
with
continued
diligence
to
post-surgical
dietary
changes.
Negative
aspects of
the
surgery
include
the
potential
for
nutrient
deficiencies
due to the
malabsorptive
component,
the need
for
stringent
dietary
and
lifestyle
changes,
and the
potential
to
experience
dumping
syndrome
(negative
body
response
to refined
sugars,
high-fat
foods, and
simple
carbohydrates).
Because of
the
extensive
research
done on
the
negative
aspects of
gastric
bypass
surgery,
most
programs
are able
to offer
detailed
diet
modification
plans to
help the
patient
overcome
any issues
that could
occur
post-operatively.
The
surgery
program,
with a
committed
follow-through
by the
patient,
should be
geared up
toward a
lifetime
of
monitoring
and have a
wide
variety of
programming
for the
patient's
whole life
needs.
The
Benefits:
Medical
Results of
Weight
Loss
Surgery
and
Subsequent
Weight
Loss
-
Elimination
or
improvement
of
diabetes
-
Decrease
in or
elimination
of
hypertension
-
Elimination
of
GERD
-
Elimination
of
most
forms
of
sleep
apnea
-
Decreased
risk
of
many
forms
of
cancer,
such
as
breast,
pancreatic,
esophageal
-
Decrease
in
fat
concentration
in
liver,
reduced
risk
of
steatohepatosis
-
Decreased
risk
of
cardiovascular
event
-
Increased
life
expectancy
averaging
20
years
-
Improvement
in
orthopedic
conditions
-
Improved
quality
of
life
Description
of the
Procedure
Gastric
bypass
involves
segmentation
of the
stomach
into a
small
pouch
(approximately
one ounce
in our
technique),
which
provides
the
restrictive
aspect.
The small
intestine
is traced
down
between
75-100
centimeters,
divided,
and the
distal
portion
brought up
and
anastomosed
to the
small
gastric
pouch,
providing
the
malabsorptive
component.
The
remaining
lower
stomach
and
bypassed
intestine
are then
patched
back into
the small
intestine
at the
point of
separation.
The body
requires
fluids
from the
stomach
for
digestion,
these are
conducted
down the
bypassed
intestine
to combine
with food
passing
out of the
small
gastric
pouch at
the point
where the
intestines
are
rejoined,
forming a
"Y"
pattern;
and
digestion
and
absorption
of
nutrients
takes
place from
this point
forward
through
the
remainder
of the
small
intestine
and colon.
The lower
stomach
still has
important
function
in the
production
of gastric
fluids for
digestion,
and the
bypassed
small
intestine
is an
important
conduit
for bile
from the
liver and
pancreatic
fluids
which are
also
necessary
for
digestion.
Gastric
bypass
surgery is
performed
conventionally
through a
five-inch
incision
extending
from just
beneath
the
sternum to
near the
top of the
navel.
Laparoscopic
techniques
have been
developed
recently
which
involve
small
incisions
and
surgery
performed
with tiny
instruments
with
visualization
on a video
screen.
The
laparoscopic
approach
offers
less
discomfort
and
quicker
recovery
times for
the
patient.
We are
happy to
offer
laparoscopic
gastric
bypass as
our
primary
surgical
technique,
however,
you will
need to
consult
with your
surgeon as
to whether
or not
this
approach
is
appropriate
for you.
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