The Roux-en-Y Gastric Bypass has been around since the 1960s, so we know the most about this procedure and it has the longest follow-up studies. It works primarily by restriction although it does have some malabsorption.
Restrictive: The stomach is divided to make a small pouch, 15-20 cc, which limits how much one can eat or drink during a given period of time.
Malabsorption: The first 100-150 centimeters of small intestine are rerouted in such a way as to “bypass” food absorption in that portion of intestine. Bile from the liver and enzymes from the pancreas don’t mix with the food to aid digestion until after the first 100-150 centimeters in intestine. There is still usually 15-20″ of small intestine left below the bypassed intestine, which is where most all medicines, antibiotics, vitamins, and minerals are absorbed and is generally unaffected by weight loss surgery. The bypass does affect the absorption of certain vitamins, so supplementation is required after surgery. Typically this involves taking an adult multivitamin, calcium, and vitamin B12. This will be discussed in detail with you at appointments.
In addition, the gastric bypass works on behavioral modification through “dumping syndrome.” Dumping syndrome is a constellation of physical symptoms that can occur if a patient with a gastric bypass eats something high in simple sugars such as a cupcake. This can cause symptoms such as nausea, abdominal pain, flushing, and diarrhea; basically, you feel horrible. This psychologically will change the way you look at sweet foods, thereby helping patients stay away from foods that got them into trouble in the first place. It can be a valuable tool to help patients stay true to a healthy diet, thereby keeping the weight off long term. This phenomena is only seen with the gastric bypass procedure. We are big fans of dumping syndrome.
About the Procedure
Traditionally, the Roux-en-Y Gastric Bypass has been done through a large upper midline incision in the abdomen. However, because of our extensive laparoscopic experience, Johns Creek Surgery Center, PC, performs the same Roux-en-Y Gastric Bypass procedure using minimally-invasive techniques. This means tiny incisions with a laparoscopic approach. Using the laparoscopic approach increases the speed of recovery, and decreases the risk of some surgical complications.
Some surgeons do not divide or disconnect the small stomach pouch from the large gastric remnant, thus greatly increasing the chance that the staple line will break down. That means that food will once again go into the large part of the stomach and the patient will regain weight. This requires repeat surgery with associated risks. The experts at Johns Creek Surgery, PC, agree with other experienced bariatric surgeons who understand the importance of disconnecting the small stomach pouch from the large stomach remnant.
Click here to use our Body Mass Index (BMI) Calculator to help determine if you are a candidate.
Aftercare and Recovery
The Roux-en-Y Gastric Bypass is the most common gastric surgery procedure performed in the United States. We typically perform the procedure in about 1 hour. The gastric bypass procedure has an excellent track record in achieving and maintaining weight. The majority of the weight-loss generally occurs over the first 12 months after surgery. Average weight loss is 60-70% of the patient’s excess weight.
There have been multiple studies showing the success in maintaining the weight loss, something no diet or exercise plan can show. Even 15 years later, there is still an average of 50-60% excess weight loss. The weight comes off and stays off, allowing for improved health. The health benefits from gastric bypass surgery are profound. Studies show up to 90% resolution of diabetes, 70-80% resolution of high blood pressure and high cholesterol, 85% resolution of sleep apnea, and almost 100% resolution of gastric reflux just to list a few of the benefits. For some health problems like diabetes or gastro-esophageal reflux, gastric bypass surgery is far superior at curing the condition than any of the other bariatric surgery procedures.
Other Weight-Loss Procedures
Johns Creek Surgery Center, PC, attracts patients from all over the metro Atlanta area and beyond including Macon, Sandy Springs, Alpharetta, Milton, Roswell, Duluth and Marietta, GA. Our Board-Certified experts provide a carefully structured weight-loss program for all patients in a comfortable, caring environment to help them through every step of their weight-loss journey and beyond.