Roux-en-Y Gastric Bypass for Weight Loss
The most popular operation in the United States right now is the Roux-en-Y gastric bypass. It's been around for over 30 years. It's been done either with an open procedure, which is a traditional big cut, but the vast majority of what we do now is laparoscopic, the smaller incisions. With the gastric bypass, we staple and divide the stomach so we essentially create a small pouch.
It's about the size of an egg or a golf ball. It's still a muscle so it'll stretch and will feel full, but that's the main reason people lose weight. You've got that small pouch. Then we will divide the small intestine further down and one of the pieces we take up to the pouch and attach it.
And then we put the other piece together further down. As you can see by the pictures, it comes together in two different places. The advantages of Roux-en-Y gastric bypass include a quicker weight loss.
That doesn't make it right for every patient, but patients will tend to lose weight more quickly at the beginning and then, obviously, it slows down as you get closer to the year mark. When too much sugar or too much carbohydrate goes through the gastric bypass and gets into the intestine, patients feel lousy. It happens maybe 20-30 minutes after they've eaten something that has too much sugar, say ice cream, a candy bar, and they feel bloated, crampy, clammy. They just don't feel well.
It doesn't physically hurt the patient, but they don't want to feel like that so they tend to avoid those foods. So that does help with weight loss. The disadvantages of the gastric bypass are that it's a more complicated operation. It takes longer and there are risks of a leak. The risk is very low.
It's less than 1%, but it still can happen. Most of them can be handled non-operatively. You can have a narrowing within the channel.
There is a risk of nutritional changes. That's why patients have to take their vitamins, so they don't get deficiencies. Most of the risks are patients' own medical risks. All the operations are done under general anesthesia so we want the patients in the best medical shape at the time of surgery.
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