Roux-en-Y Gastric Bypass
Arguably, the “Gold Standard” in obesity surgery is the Roux-en-Y Gastric Bypass. This procedure involves both a “ restrictive ” procedure by decreasing the size of the stomach by stapling across the top of it and a “ malabsorptive ” component, achieved by bringing-up and attaching a portion of the small intestine directly to the stomach, thus “ bypassing ” part of the small intestine.This surgery causes gastrointestinal hormonal changes, which result in decreased hunger and improved satiety or fullness. Individuals undergoing this surgery will lose significant amounts of weight (mainly body fat as opposed to lean body mass or muscle tissue). Weight maintenance is generally excellent with small increases in weight occurring over subsequent years. Like any obesity surgery, the patient will require lifelong vitamin supplements & regular periodic follow-up to preventive any vitamin, iron, calcium deficiencies.
Surgical Results, Complications, and Nutritional Deficiencies
After 2 years from the surgical procedure, on average patients lost approximately 60- 80 % of excess body weight lost
Major complications related to this specific surgery are less than 3-4 % and include:
1- Marginal Ulcers at the site of attachment of the intestine to the stomach.
2- Stomal stenosis (narrowing)at the stomach outlet, resulting in nausea and vomiting
3- Leakage of intestinal contents
4- Stomach staple line disruption resulting in the ability to consume large volumes of food
5- Dumping Syndrome wherein consumption of food (especially carbohydrates) results in nausea, vomiting, diarrhea, abdominal pain, flushing, rapid heartbeats.
Nutritional Deficiencies from Roux-en-Y Gastric Bypass are specifically Iron, Vitamin B12, Folate, Vitamin D, Calcium, Thiamine, Protein, therefore patients need regular supplementation and follow up with your doctor.
This procedure is carried out usually laparoscopically, which offers faster surgical recovery & enhanced safety.
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