The gastric bypass, or Roux-en-Y Gastric Bypass, is the oldest and most commonly performed bariatric surgery procedure. It consists of cutting and stapling the stomach to create a smaller pouch while also re-routing the intestines. 

Gastric bypass surgery helps patients lose weight by restricting the amount of food a patient can consume and creating a malabsorptive effect. We also believe this procedure will recalibrate the body’s metabolic set point. The gastric bypass is a reversible operation and can be revised to another procedure if needed.

How Gastric Bypass Surgery is Performed

This gastric bypass is performed using a minimally invasive technique that makes small incisions in the stomach to access the abdominal cavity. The surgeon will divide the stomach into two parts during the gastric bypass operation—the small gastric pouch at the top and the larger, separate section at the bottom. The small intestine is then divided a few feet from the stomach and brought up to meet the small gastric pouch. 

The new, smaller stomach is now about the size of an egg. As a result, patients will feel full faster, thereby eating less. Also, when food bypasses the stomach, this causes fewer calories and nutrients to be absorbed, creating a malabsorptive effect. 

Malabsorption is the difficulty in digesting and absorbing nutrients from food. It is common in post-bariatric patients due to the re-routing of the intestines and lower food intake. This is why it is so important to take your vitamins after surgery. 

Additionally, we believe that diverting food away from the upper part of the intestines (duodenum) will recalibrate the body’s metabolism through hormonal mechanisms. 

The gastric bypass takes about 1 hour to perform, and patients can expect to stay at the hospital for 24 to 48 hours after surgery. Depending on the type of work performed, patients will be able to return to work within 2 to 4 weeks from surgery.

Gastric Bypass Surgery Results

The gastric bypass is usually reserved for patients with a higher BMI (40+) or severe type 2 diabetes or metabolic syndrome. It offers slightly more weight loss than a gastric sleeve, with an average excess weight loss between 70 and 80%. Patients who achieve greater success after gastric bypass surgery are those individuals who follow their surgeon and dietitians’ instructions and incorporate exercise into their daily activities.

Around 80% of diabetic patients who have gastric bypass surgery will be cured of their diabetes, and over 60% will reduce their medication usage. 

Potential Risks of Gastric Bypass Surgery

Before considering gastric bypass surgery, it is crucial to be familiar with the potential risks of all bariatric procedures. Risks vary based on the health of the patient.

Some minor complications that are uncommon but can be managed fairly easily include: 

• Minor wound or skin infection
• Excess / loose skin
• Vomiting or nausea
• Acid reflux (heartburn)
• Changes in bowel habits like constipation, diarrhea, bloating, cramping, or gas
• Gastric ulcer or anastomotic stricture
• Development of gallstones or gallbladder disease
• Nutritional deficiencies as a result of food bypassing the stomach
• Dumping syndrome when high sugar foods move too fast from the stomach to the small intestine

Other, more serious complications that could result in re-operation include: 

• Internal Bleeding
• Intestinal obstruction
• Blood clots in the legs or lungs
• Internal hernia
• Perforation of stomach/intestine or leakage

The good news is that complications post-surgery are rare. “The most serious complication is an anastomotic leak, which occurs in 0.7% to 5% of patients, with the leak rate significantly lower in contemporary laparoscopic settings.” 

However, a GI hemorrhage (heavy bleeding in the upper parts of the digestive tract) is more common in laparoscopic procedures than in old-fashioned open procedures. Yet again, this complication is rare, with less than 1% of all gastric bypass patients will experience post-operative bleeding.

In general, the gastric bypass is a highly safe and effective operation that should be considered in patients looking to lose an extreme amount of weight. 

This article was originally published on the Bariatric Centers of America website.