Roux-en-Y Gastric Bypass

Roux-en-Y Gastric Bypass

Roux-en-Y Gastric Bypass

Roux-en-Y Gastric Bypass (RYGB) is a type of weight-loss surgical procedure (bariatric surgery) utilizing laparoscopic surgery with small incisions to the patient's abdomen.

During bypass surgery the surgeon creates a "new" stomach with a smaller volume so that the patient will consume less food and calories, leading to subsequent weight reduction.

Gastric bypass surgery which is used to treat severe obesity is recommended for patients who have tried other methods of losing weight with no positive results. The doctor may also recommend this type of bariatric surgery to patients:

  • suffering from severe obesity with a body mass index (BMI) over 40,
  • with a body mass index (BMI) from 35 to 40, who suffer from sleep apnea, cardiovascular diseases, type 2 diabetes, and high blood pressure.

Roux-en-Y shunting is an effective form of treatment for diseases associated with obesity. The following advantages of this form of treatment are noted below:

  • high chance of reducing excess weight by approximately 45 kg,
  • possible remission of type 2 diabetes,
  • remission of heartburn and reflux disease,
  • lowering of high blood pressure,
  • reduction of the risk of sleep apnea and the prevention of various illnesses related to the cardiovascular system.

However, like any surgical procedure, Roux-en-Y shunting is associated with certain risks and complications, such as:

  • bleeding and infections,
  • individual intolerance to anesthesia or problems with the respiratory system,
  • low level of vitamins if patients do not take vitamin and mineral complexes after surgery,
  • low levels of iron and calcium,
  • problems with digesting the required amount of protein,
  • dumping syndrome, nausea, heart palpitations, abdominal cramps, fainting and diarrhea after eating,
  • internal hernia formation,
  • the need for an additional operation,
  • unsatisfactory weight loss results,
  • a return to previous body weight if patients continue to eat high-calorie foods and do not engage in exercise.

There may be other risks; therefore prior to bariatric surgery patients should seek medical advice and discuss the health benefits and potential risks with their doctor.

Roux-en-Y Gastric Bypass Surgery - Patient Information

Treating physicians should be confident that gastric bypass surgery is the best form of treatment on a case-by-case basis. This type of weight loss procedure is contraindicated with the following patients:

  • drug or alcohol abusers,
  • patients who are not ready (unwilling) to positively adjust their lifestyles.

Some clinics require patients to complete an educational program to help them prepare for life after bypass surgery. While participating in this program (as well as in some clinics), patients will receive advice on proper nutrition. Before bypass surgery patients undergo examinations and diagnostics; in some centers patients also need to consult a psychologist or psychiatrist.

Before their operation patients need to:

  • quit smoking (several months prior to bypass surgery),
  • (at the request of the surgeon) start losing weight, as this will reduce the size of their livers and the risks associated with surgery,
  • stop taking medications that affect blood clotting (a few days before bypass surgery),
  • stop eating or drinking the night before surgery.

The operation usually takes several hours and is performed under general anesthesia. Currently, most operations are performed laparoscopically, which leaves the patient with only a few small incision marks.

During the operation, the surgeon does not remove any internal body parts, creating just a new configuration of the gastrointestinal tract. As a result of bypass surgery, the patient's stomach reduces in size, resulting in a comparative reduction in hunger invariably leading to the consumption of smaller portions of food.

Usually, a patient will stay in the clinic for 1-2 days during which the surgeon will explain how to properly care for the surgical wound and will also provide valuable advice on when one can start exercising.

Patients should immediately contact a doctor if the following symptoms appear:

  • high body temperature,
  • the postoperative wound becomes painful or hot to the touch, or fluid starts to leak from the wound,
  • coughing or trouble breathing,
  • vomiting and diarrhea,
  • pain in the abdomen, chest, shoulder or legs,
  • any other problems or symptoms.

In most cases, patients consume liquid food during the first two weeks after surgery. Then, gradually patients can switch to a soft diet, and after a month they can start eating regular food.

Patients usually lose excess weight quickly in the initial phase; during this period, it is very important to monitor nutrition intake. Your doctor should advise you on what vitamin and mineral complexes you need to take since it will become more difficult for the body to absorb vitamins and minerals from regular food.

To prevent problems during rehabilitation in the postoperative period doctors recommend that patients take:

  • Daily multivitamin and calcium supplements,
  • Vitamin B12 to prevent limb fractures. Frequency, form, and dosage should be discussed with one’s physician,
  • Vitamin D level if the patient's level is low; the dosage and duration of vitamin D intake should be discussed with one's doctor,
  • Iron supplements and vitamin C, in doses recommended by one's physician.

After Roux-en-Y shunting, the patient's body may be deficient in nutrients, so doctors recommend blood tests at least once every 6 months (for life) to confirm the required amount of vitamins and minerals.

While losing weight, patients may experience body aches, dry skin, mood changes, and temporary hair loss, as well as a feeling of tiredness and cold. When weight stabilizes, these problems should disappear. Weight loss continues for about a year and then stabilizes; during the first year, patients will need to take care of their psychological health and develop routines that include regular exercise and the eating of nutritious foods which help stabilize their “new” weight and prevent a return of the pre-op excess weight.

Many bariatric patients not only undergo a check-up after surgery but also consult a nutritionist for advice on foods that can be consumed post-op. Some patients also see a psychologist or psychiatrist to help process their feelings and fears connected to inevitable lifestyle changes and their new physical appearance.

Gastric bypass surgery creates the opportunity for a new start and an increase in quality of life for many patients. Following one's recommended diet before and after surgery is essential to continued success; the provision of a precise, comprehensive diet can protect patients from postoperative complications and provide guidance on how to eat properly for the rest of their lives.

Roux-en-Y Gastric Bypass - FAQ

Which foods are allowed and prohibited after bypass surgery?

Diet recommendations after gastric bypass surgery differ according to each patients’ unique circumstances although there is inevitably some commonality. However, care must be taken at every stage when dieting. Common recommendations are as follows:

  • eat and drink slowly to avoid dumping syndrome, nausea, vomiting, dizziness, sweating, and diarrhea,
  • Eat a low-fat protein-rich food daily,
  • choose foods and drinks that are low in fat and sugar,
  • avoid drinking alcohol,
  • limit the use of caffeine,
  • chew food thoroughly.

At home, many foods can be chopped using a food processor, blender, or other similar devices. Hot and spicy food can irritate the stomach, so avoid these items entirely. Avoid fruit varieties with large amounts of seeds like strawberries or kiwi, and vegetables that are too fibrous like broccoli and cauliflower.

Instead, choose foods such as applesauce, bananas, canned fruits, peaches, apricots, pears, pineapples, melons in the fruit category; spinach, carrots, zucchini, green beans for vegetables; yogurt, cottage cheese, ricotta cheese, beef, chicken, turkey, white fish (cod, tilapia, haddock), and omelets for protein.

During the first four months after bypass surgery, it is recommended to avoid eating foods such as pea pods, popcorn, soft drinks, tough meat, fried foods, dried fruits, etc.

Does bypass surgery affect men's sex lives?

According to research published in the Journal of Clinical Endocrinology and Metabolism (Oxford), hormonal changes and decreased quality of sex life among obese men are symptoms directly related to their degree of obesity. Both indicators improve after gastric bypass surgery.

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