Roux-En-Y Gastric Bypass

What is 'roux-en-Y gastric bypass' surgery?

A roux-en-Y gastric bypass is where we make a very small pouch at the very top of the stomach and then bring the intestines up to allow that food to go into the rest of your system by bypassing the whole rest of the stomach, which is bypassing 95 percent of the stomach, and bypassing, depending on the surgery you're doing, the entire duodenum and part of what we call the jejunum. So, in the short-limb gastric bypass, we bypass about 100 centimeters of intestine, and in the long-limb, maybe 250 centimeters of intestine.

Can rouex-en-Y gastric bypass be dangerous or fatal?

The rouex-ey-Y gastric bypass has a mortality rate of between .2 and .4 percent done in centers of excellence where people have a lot of experience with that procedure. The laparoscopic gastric band has a mortality rate of about .1 percent or 1 in 1000. The other procedures have rates about the same depending whether it's a restrictive procedure or the gastric bypass.

When is roux-en-Y gastric bypass surgery used?

Roux-en-Y gastric bypass surgery again is a patient choice and a physician choice. In the United States it's considered the gold standard for bariatric surgery. All other procedures are measured against the gastric bypass for morbidity, mortality, success rate all those types of things. If the patient has severe diabetes, I usually would like the patient to have a gastric bypass. Some patients don't want to have that, they still want to have the band in. That's fine that, it's still a good procedure. But the choice again, after the patient is well informed about everything and they've researched everything, is made by the patient, unless there are some medical complications.

What are the advantages and disadvantages of roux-en-Y gastric bypass surgery?

The advantages of having the roux-en-Y gastric bypass is the weight loss occurs over the first nine, 12, 18 months; whereas restrictor procedures, mostly the adjustable band, the weight loss is 18 months to 36 months. So patients may say, "I want to lose the weight faster." The patient who is diabetic seems to have a more successful relief of their diabetes with gastric bypass; again, something that's being worked out, scientifically, why that would be. Some of the disadvantages of the bypass is the higher complication rate, malabsorption of protein, which doesn't happen frequently if we're using the proximal gastric bypass. It happens more frequently with the distal gastric bypass. But both of the procedures have a malabsorption of iron and some vitamins, especially Vitamin B-12 and somewhat of Vitamin B-1. They can become very serious problems. Somebody who is deficient in Vitamin B-1 can get neurological problems and even have permanent neurological damage if it's not caught in time. The mortality rate being higher is certainly a disadvantage of the procedure.

What are the chances of gaining weight after roux-en-Y gastric bypass surgery?

The chances of gaining weight back after roux-en-Y gastric bypass are about 20-30% over a 5-10 year period. Usually the patient finds a way around the procedure, or they eat so fast that they stretch everything out so they can eat more and then they start eating like they were before.