Gastric Bypass Roux En Y

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  What is Roux-en-Y Gastric Bypass? Gastric bypass, also known as Roux en Y gastric bypass, is a form of weight-loss surgery for which a small pouch is created from the stomach and subsequently connected directly to the small intestine. After gastric bypass surgery, foods consumed will go into this newly created small pouch in the stomach, […] Read More

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Gastric Bypass Roux En Y

 

What is Roux-en-Y Gastric Bypass?

Gastric bypass, also known as Roux en Y gastric bypass, is a form of weight-loss surgery for which a small pouch is created from the stomach and subsequently connected directly to the small intestine. After gastric bypass surgery, foods consumed will go into this newly created small pouch in the stomach, from which it then directly enters the small intestine. In doing so, most of the stomach and the first section of the small intestine are bypassed. The laparoscopic RY gastric bypass is a minimally invasive surgery. This is performed by introducing a laparoscope connected to a video through small abdominal incisions. The surgery is performed “inside” the abdomen after the CO2 gas has been inserted to expand it. Special stapling instruments separate about 5% of the stomach to create a new small Gastric Pouch. The remaining 95% of the stomach (Excluded Stomach) is not removed. It continues to produce digestive juices and some essential factors. The small intestine (Roux limb) connects to the newly formed gastric pouch outlet. Then, bypassing the stomach, food empties directly into the lower portion of the intestine (Small Intestine Common Channel). The name, Roux-en-Y gastric bypass, is gotten from the technique in which the digestive juices produced by the stomach, pancreas, gall bladder, and duodenum are directed by the Bilio-Pancreatic Limb back into the common channel in the shape of a “Y” hookup.  By diverting a part of the intestine, the small-sized Gastric Pouch makes patients feel full quicker, eating a reduced meal portion (restriction). This means that there is malabsorption which means that the patient’s body is only able to absorb very few calories. When serious health problems occur due to an individual’s weight or when diet and exercise do not affect the condition, Gastric bypass is resorted to.  Carrying out Roux-en-Y gastric bypass reduces excess weight and potentially life-threatening risks related to weight health problems. For instance; The small Gastric Pouch causes patients to feel full sooner and eat less (restriction); bypassing a portion of the intestine means the patient’s body absorbs fewer calories (malabsorption) Gastric bypass is resorted to when diet and exercise have failed to work or when weight has led to serious health problems.  Gastric Bypass – Roux-En-Y Picture Courtesy: Hospital. uillinois

Reasons for a Roux-en-Y Gastric Bypass.

Roux-en-Y gastric bypass is carried out to help reduce excess weight and the risk of potentially life-threatening weight-related health problems. For instance;
  • Gastro-oesophageal reflux disease.
  • Heart disease.
  • High blood pressure.
  • High cholesterol
  • Obstructive sleep apnea.
  • Type 2 diabetes.
  • Stroke.
  • Cancer.
  • Infertility.
Preparation for a Roux-en-Y Gastric Bypass. The patient must take the following steps to ensure a successful procedure.
  • Start a physical activity program and quit all tobacco use a few weeks before the procedure. 
  • Restrictions on eating and drinking and medications can be used right before surgery.

Roux-en-Y Gastric Bypass surgery procedure. 

The procedure is carried out under general anesthesia.  The Roux-en-Y Gastric Bypass surgery procedure is carried out with the traditional large (open) incision method in the abdomen. Due to technological advancement, most surgeries are now performed laparoscopically, which involves the insertion of instruments through the multiple small incisions made in the abdomen. After making the incisions by either the open or laparoscopic technique, the top of the stomach is then cut and sealed off from the rest of the stomach. However, the resulting pouch is small and can only hold about an ounce of food, unlike the stomach, which normally holds about 3 pints of food. The small intestine is then cut, and part of it is sutured directly onto the newly created small pouch. So when the next food is consumed, it goes straight into this new pouch of the stomach, from where it directly goes into the small intestine sutured to it. In other words, any food consumed after the surgery bypasses most of the stomach and the first section of the small intestine and goes directly into the middle part of the small intestine. The surgical procedure lasts for a few hours, and after the surgery, the patient is initially shifted to ICU (Intensive Care Unit) to monitor the vitals closely. Once the patient is hemodynamically stable, the patient is then shifted to a recovery room for further management and care.

The aftermath of a Roux-en-Y Gastric Bypass surgery

The patient is initially allowed to take only fluids after gastric bypass surgery until the stomach and intestines completely heal. Once the patient is comfortable with liquids, the doctor slowly recommends the patient to have pureed food followed by soft food and later normal food. The patient needs to follow a strict diet after the procedure and is advised to take supplements such as vitamins and minerals, which include iron, calcium, Vit B12, etc. Frequent medical check-ups will be scheduled for health monitoring in the first several months after gastric bypass surgery. This may include laboratory testing, blood work, and various exams.  Roux-en-Y Gastric Bypass surgery outcome  Roux-en-Y Gastric Bypass surgery outcome Picture Courtesy: weight-loss surgery A successful Roux-en-Y Gastric Bypass can provide long-term weight loss, to the tune of about 70%, or even more, of the excess weight within two years. However, the amount of weight loss depends on changing lifestyle habits.  The gastric bypass may help improve or resolve conditions that are often related to being overweight, such as;
  • Gastro-oesophageal reflux disease.
  • Heart disease.
  • High blood pressure.
  • High cholesterol.
  • Obstructive sleep apnea.
  • Type 2 diabetes.
  • Stroke.
  • Infertility.

Causes

A number of factors are responsible for a person to become morbid and obese. A few of them are listed here but are not exhaustive:

– Food and activity – one of the most common causes – when food intake is more than the required physical activity to burn it off.

– Environment – not having access to physical activity, sedentary work activities.

– Stress and Emotional factors.

– Genetics

FAQ

Will I experience any changes to my body system?

Yes. The person is likely to experience changes in the first 3 to 6 months after a Roux-en-Y gastric bypass while the body reacts to rapid weight loss. Some of the likely changes are;

  • Body aches.
  • Feeling tired, as if you have flu.
  • Feeling cold and feverish.
  • Dry skin.
  • Hair thinning and hair loss.
  • Mood changes.

When does a Roux-en-Y Gastric Bypass surgery fail?

There’s a possibility that one may not lose enough weight or even regain weight after Roux-en-Y Gastric Bypass surgery. Gaining weight can result from strictly not following the recommended lifestyle changes. For instance, frequent snacking on high-calorie foods may lead to inadequate weight loss. Therefore, to avoid regaining weight, permanent healthy changes must be made to the diets and engaging in regular physical activity and exercise.

What are the side effects of Roux-en-Y Gastric Bypass surgery? 

Roux-en-Y Gastric Bypass side effects include;

  • Excessive bleeding.
  • Infection.
  • Adverse reactions to the anesthesia given.
  • Blood clots.
  • Lungs or breathing problems.
  • Leaks in the gastrointestinal system.

Who is a Roux-en-Y Gastric Bypass surgery for?

Roux-en-Y Gastric Bypass surgery is used to treat severe obesity with a body mass index (BMI) of over 40`. It can also be a last resort treatment for people who have tried other weight loss methods without long-term success. 

Roux-en-Y Gastric Bypass surgery may also be recommended for people with BMI between 35 and 40 and for health conditions like sleep apnea, high blood pressure, heart disease, or type 2 diabetes.

How long does a Roux-en-Y Gastric Bypass surgery last?

A Roux-en-Y Gastric Bypass surgery lasts roughly about 2 -3hours.

What are the advantages of a Roux-en-Y Gastric Bypass surgery?

  • Average weight loss is greater than in other procedures.
  • More rapid weight loss than with the Lap-Band, if dietary guidelines are strictly followed.
  • Roux-en-Y Gastric Bypass doesn’t require any devices to stay inside.
  • It is highly efficient, and a person can lose about 100 pounds of excess weight. 
  • It may help to reverse type 2 diabetes and put a stop to heartburn and reflux. 
  • It can also lower high blood pressure, sleep apnea, and certain heart problems.

What are the disadvantages of a Roux-en-Y Gastric Bypass surgery?

  • Roux-en-Y Gastric Bypass recovery time may take a bit longer than it should because of the rerouting of the digestive organs. 
  • There causes more and more severe pain.
  • The procedure reduces one’s ability to absorb nutrients and calories.
  • One will need to be on vitamin supplements for the rest of their life.
  • The patient must follow low-sugar and low-starch diet guidelines after surgery.
  • The procedure is irreversible.

What are the complications of Roux-en-Y Gastric Bypass surgery? 

The longer-term risks and complications of Roux-en-Y Gastric Bypass surgery may include;

  • Bowel obstruction.
  • Dumping syndrome can lead to diarrhea, nausea, or vomiting.
  • Gallstones.
  • Hernias.
  • Hypoglycemia (low blood sugar).
  • Malnutrition.
  • Stomach perforation.
  • Ulcers.
  • Vomiting.

Rarely, Roux-en-Y Gastric Bypass surgery complications can be fatal.