Depending on the size of the patient, the Roux-en-Y can be performed through a very small incision with laparoscopic techniques or through a larger incision, in an operation known as open surgery. The stomach pouch is created by stapling or banding part of the stomach together. That limits how much food the patient can hold. Then, a Y-shaped section of the small intestine is attached to the pouch to allow yet more food to bypass that section of the intestines where many nutrients, and calories, are absorbed.
The extensive gastric bypass, a large part of the stomach is surgically removed to create a small food pouch. This operation promotes rapid weight loss but is not widely used because it creates a high risk of nutritional deficiencies and additional problems for the patient.
Patients can expect major swelling, bruising, some pain and post-operative hospitalization. Usually, your doctor gives you prescription medications to control any discomfort. The procedure is usually performed in a hospital operating room.
People who have gastric bypass operations usually lose two-thirds of their excess weight within two years after the operation. The food pouch initially holds about one ounce of food and expands to two to three ounces over time. The small outlet delays the emptying of food from the pouch and causes a feeling of fullness so the patient eats less.
Because the body does not absorb many nutrients after gastric bypass, anemia can be a long-term effect. That, in turn, can lead of osteoporosis and metabolic bone disease. Thus, gastric bypass patients must take nutritional supplements that usually prevent such deficiencies. Many patients require not only close monitoring but also the life-long use of special foods and medications. After gastric bypass surgery, your body will not easily tolerate meals that are high in sugars and fats, foods that may make you physically uncomfortable and are usually avoided. All those changes allow people highly prone to overweight to lose weight and keep it off for the long term. Moreover, recent studies have shown that gastric bypass result in altering the release of hunger-causing hormones so that the patient’s appetite is reduced.
Once their weight has been stabilized at normal levels for at yeast a year, gastric bypass patients usually need yet another operation known as body shaping to remove large amounts of excess skin which has been extremely stretched by the massive overweight.
The operation has about a 1% death rate and is higher than those of other primary operations. Immediately following surgery, possible risks include incision infections, the wound bursting open (dehiscence,) leaks from staple breakdown, marginal ulcers, various pulmonary problems and deep clotting in veins (thrombophlebitis.) About ten percent of patients suffer some post-op complications.
Moreover, the way a patient eats will be forever changed; many patients must eat eight to ten small meals a day to obtain enough nutrients and can drink nothing while eating because the pouch can’t hold both liquid and food. Because the pouch can hold so little food, patients are routinely told to eat protein first because that is the most necessary nutrient.
Additional risks include:
- Pouch stretching. Over time, and because of eating too much, the stomach gets bigger and stretches back to its normal, pre-surgery size.
- Band erosion. The band that closes off part of the stomach disintegrates.
- Breakdown of staple lines. The band or staples fall apart and return the stomach to its pre-operative size.
- Leakage. Stomach contents can leak through the stitches. That’s dangerous because the acid can eat away at other organs.
- ”Dumping” Syndrome. Stomach contents can move too rapidly through the small intestines. Problems caused can include nausea, weakness, sweating, flatulence and, occasionally, diarrhea after eating, as well as the inability to eat sweets without becoming extremely weak.