Roux-en-Y gastric bypass (RYGB), commonly called “gastric bypass,” is one of the most popular bariatric procedures worldwide and has long been considered the “gold standard” of bariatric surgery.

Gastric bypass is performed using minimally invasive techniques known as laparoscopic surgery. It is performed routinely in less than an hour or two and the hospital stay is one day. The incisions, usually five, are one cm or less in size, so recovery is very fast and pain is minimal. In the right center and with certified and qualified personnel, this is a very safe surgery.

It consists of dividing the stomach into two chambers with staples. The upper chamber receives food and is very small and has a capacity of about 30 ml. The lower chamber is “bypassed” and receives no food. The small intestine is divided and one end is connected (“anastomosed”) to the pouch. A second connection (“anastomosis”) is made to connect the disconnected stomach to the small intestine. This connection allows digestive fluids to meet ingested food to allow for breakdown and absorption of nutrients. The distance between the two connections can vary depending on the surgeon’s preference, but is generally 50 to 150 cm.

After the procedure is complete, food travels directly from the small gastric pouch to the small intestine bypassing the lower stomach, duodenum, and upper part of the small intestine (jejunum).

Gastric bypass helps obese people lose weight in different ways. The small bag restricts the amount of food that can be eaten. The connection between the small intestine and the gastric pouch redirects the transit of food directly to the small intestine. Since food bypasses the part of the stomach and duodenum that is bypassed, metabolic and hormonal changes occur, resulting in reduced appetite and increased feelings of fullness.

After bypass surgery, patients can expect to lose about 70-80% of excess weight. The maximum effect on weight loss is normally seen during the first two years.

In addition to weight loss, several obesity-related diseases tend to improve after surgery. These include type 2 diabetes, hypertension, dyslipidemia, metabolic syndrome, fatty liver disease, and obstructed sleep apnea. In fact, more than 70% of patients with type 2 diabetes will experience normalization of their blood sugar levels and will stop taking all of their antidiabetic medications or require significantly less medication.

It is important that you find a surgeon with the appropriate certifications and experience to advise you on all of your options.

Disadvantages

• Increased risk of some vitamin and mineral deficiencies: B12, D, iron, and calcium in particular.
• Increased risk of gallstones
• Increased risk of ulcers if you take NSAIDs or smoke
• Intestinal obstruction
• Dumping syndrome (low blood sugar)
• Risk of alcohol dependence due to faster absorption