ARH Bariatrics

Laparoscopic Gastric Bypass

This procedure is the most commonly performed bariatric surgery in the nation today. The laparoscopic Roux-en-Y gastric bypass procedure involves making several small incisions through which the surgeon inserts laparoscopic instruments to perform the surgery.

The procedure is designed to make a small reservoir (pouch) for food at the upper end of your stomach with a capacity of about 2 oz. This pouch is connected to the upper small intestine by a new small anastomosis (outlet) of about ½ inch (1.2 cm) in diameter. The ingested food thereby bypasses the majority of your stomach, which remains alive and undisturbed, but functional otherwise. In other words, the majority of your stomach does not have food passing through. It often is associated with a permanent decrease in appetite. The nature and purpose of this operation is to functionally limit the amount of food or liquid intake at any given time. There is a small component of malabsorption, at least initially. This procedure is often associated with fairly rapid weight loss initially, which stabilizes over time to a weight that is healthy for you.

Advantages of the Laparoscopic Roux-en-Y Gastric Bypass:

• Weight loss averages 60 –70% excess body weight within one year after surgery
• Proven long term effectiveness – studies show that after 10 – 14 years, patients still maintain 50 – 60% excess body weight loss.
• Studies show that 90% of obesity-related medical problems such as hypertension, sleep apnea, heartburn (gastroesophageal reflux disease/GERD), adult-onset diabetes, cardiac function, and depression to name a few, improve or are completely resolved.
• If performed laparoscopically, the gastric bypass IS REVERSIBLE laparoscopically.

Disadvantages/Risks of the Roux-en-Y Gastric Bypass:

• Potential for protein, vitamin, and mineral deficiency in non-compliant patients .
• Commitment to the program for optimal results .
• “Dumping” – a symptom complex that can involve sweating, flushing, diarrhea, nausea, or vomiting, pain that occurs after eating foods high in fat or sugar content.
• Stretching of the stomach pouch or outlet over time secondary to overeating.
• Decreased imaging capabilities of the bypassed stomach, duodenum, and segments of the small bowel.
• Strictures (narrowing) of the outlet requiring Endoscopic dilatation.
• “Leak” (1%) which if untreated, can lead to severe peritonitis. If addressed appropriately and early, a leak is usually well controlled with good outcomes.