Roux-en-Y Gastric Bypass Procedure
Expected weight loss 60-80% of excess weight

Description of the Roux-en-Y Gastric Bypass Procedure

Second most common weight loss surgery performed in the U.S. (less than half as much as sleeve gastrectomy) and was previously considered the gold standard of weight loss surgery.

Dr. Feng creates a small, upper stomach pouch about 1 ounce in size, dividing it from the lower stomach. This significantly restricts the volume of food that can be eaten if solid protein eaten first. This reduces the amount of calories that can be eaten. He then divides the small intestine to create a Y-shaped section to attach to the stomach pouch. The lower stomach and a portion of the small intestine is bypassed which causes malabsorption of certain nutrients, with no significant carbohydrate or fatty food malabsorption. The procedure minimally limits the nutrients the body can absorb because of the bypass.

Click Here to watch an interactive video of the Roux-en-Y Gastric Bypass Procedure

Advantages of Roux-en-Y Gastric Bypass Procedure

• May be more effective in in some studies in improving obesity-related health problems than some restrictive procedures
• Rapid weight loss
• The portion of the stomach producing hunger-stimulating hormones is bypassed, and thus less hunger is experienced in the first year after surgery but hunger usually returns after about 9 months after surgery
• Better weight loss than the Adjustable Gastric Band procedures

Disadvantages of Roux-en-Y Gastric Bypass Procedure

• Successful results depend on the willingness to adopt long-term lifestyle changes
• Patients may experience long-term nutritional deficiencies, more so than the restrictive procedures
• Decreased absorption of calcium may bring on osteoporosis and related bone diseases
• Decreased absorption of iron and vitamin B12 may lead to anemia
• Weight loss may be slower than more malabsorption procedure type like the duodenal switch
• “Dumping Syndrome” reaction usually occurs when meals high in refined sugars, carbohydrates, or rich fatty foods are consumed
• Patients must avoid aspirin, NSAIDs such as ibuprofen, Motrin, Advil, naprosyn to avoid high risk of marginal ulcers that can cause bleeding, perforation, abdominal infection
• Possible risk of long-term permanent severe hypoglycemia episodes from nesidioblastosis, which may need high risk reversal

Risks of Roux-en-Y Gastric Bypass Procedure

• Leakage
• Infection
• Vitamin and mineral deficiencies
  
• Anemia
• Osteoporosis
• Strictures at the stomach pouch connection to intestine
• Intestinal ulcers at margin of connnection to stomach pouch
• Bowel Obstruction from internal intestinal scars, internal hernias or telescoping small intestine (intussusception)
  
• Dumping syndrome
• Gallstones
• Possible nesideoblastosis disease causing severe hypoglycemia issues
• Combined operations are more likely to lead to complications then restrictive operations
  
• Weight regain