Dr. Betsy Dovec wearing a scrub cap, surgical face mask, and surgical gown performing laparoscopic surgery

Gastric Bypass: Exploring the Gold Standard for Bariatric Surgery 

Are you considering gastric bypass surgery for weight loss but want to understand more about the procedure? Look no further as we delve into the Laparoscopic Roux-En-Y Gastric Bypass (aka – LRYGB; RNY; Roux-En-Y; Gastric Bypass; Bypass) and explore why it is considered the gold standard for bariatric surgery.

Want to see it? Watch our DoctorXDietitian unedited gastric bypass episode HERE.

The highlights

The Gastric Bypass takes the stomach from roughly the size of a football to the size of a thumb.  The new gastric pouch is approximately 5% of the size that it was.  The remaining 95% of the stomach remains inside of the patient, but it is bypassed from seeing and storing food.  The bypassed stomach still functions to make digestive juices and enzymes that will aid in digestion downstream when they meet up with food and drink that is consumed at the lower connection that looks like the letter “Y”.

The Gastric Bypass takes about one hour to perform.  It is usually a same day discharge (outpatient procedure) in the properly selected patient.  Patients usually return to work within one week. 

The benefits are countless:

  • Boasts excellent weight loss results – ~80-85% excess body weight loss (i.e., if you ideally should weigh 150 pounds, but you weigh 250 pounds, you have 100 pounds of excess weight.  You can expect to lose around 80% of your excess weight about 12-18 months after surgery) 
  • Boosts metabolism 
  • Alters hunger hormones 

Gastric bypass surgery is a weight loss solution that aids individuals with obesity in achieving long-term success. By reducing the size of the stomach and rerouting the digestive system, this procedure allows for significant and sustainable weight loss. But what makes it so effective? 

In this comprehensive BodyByBariatrics blog, we will unlock the secrets behind gastric bypass and delve into the science behind its success. From understanding how the surgery works to exploring the benefits and potential risks, we aim to provide you with a clear and informed perspective. 

Join us as we demystify gastric bypass surgery and explore why it remains the gold standard in bariatric procedures. Whether you are a healthcare professional or an individual considering the surgery, this blog will provide you with valuable insights to help you make an informed decision.

What is gastric bypass surgery?

Gastric bypass surgery, also known as Roux-en-Y gastric bypass (RYGB), is a surgical procedure that involves reducing the size of the stomach and rerouting the digestive system. The surgery is performed laparoscopically, using small incisions, and is considered a safe and effective treatment for obesity. 

During the procedure, the surgeon creates a small pouch at the top of the stomach, which limits the amount of food a person can eat. The small intestine is then rearranged to bypass a portion of the stomach and the upper part of the small intestine. This bypass reduces the absorption of calories and nutrients, resulting in weight loss. 

Gastric bypass surgery is typically recommended for individuals with a body mass index (BMI) of 40 or higher, or for those with a BMI of 35 or higher who have obesity-related health conditions such as diabetes, high blood pressure, or sleep apnea.

Isn’t the bypass more invasive though?!

No! The notion that Laparoscopic Roux-En-Y Gastric Bypass (LRYGB) is more invasive than traditional open surgeries is a misconception that fails to consider the advancements in surgical techniques. In fact, laparoscopic procedures are characterized by their minimally invasive approach, which involves making small incisions rather than one large one. This technique allows Dr. Dovec and Dr. Lane to access the abdomen using specialized instruments and a camera, resulting in less postoperative pain and faster recovery times compared to open surgeries.

Laparoscopic or minimally invasive techniques have revolutionized the field of surgery by providing patients with safer and more efficient treatment options. By utilizing small incisions and advanced technologies, laparoscopic procedures minimize blood loss, reduce the risk of infection, and shorten length of stay. In fact, the majority of our patients will go home the same day from the recovery room. Additionally, the enhanced visualization provided by laparoscopic cameras allows for greater precision and accuracy during surgeries. Patients undergoing laparoscopic procedures typically experience less scarring and enjoy faster recovery times, enabling them to return to their normal activities sooner.  

Benefits of gastric bypass surgery 

The benefits of gastric bypass surgery extend beyond just weight loss. This procedure has been shown to provide significant improvements in various obesity-related health conditions, including type 2 diabetes, high blood pressure, and sleep apnea. 

One of the primary benefits of gastric bypass surgery is its ability to promote long-term weight loss. Studies have shown that patients can expect to lose ~80-85% of their excess body weight, with the majority being within the first year after surgery. This weight loss can have a profound impact on overall health and quality of life. 

In addition to weight loss, gastric bypass surgery can lead to improvements in metabolic health. Many patients experience a resolution or improvement in type 2 diabetes, with some even achieving complete remission. This can happen as soon as the moment the patient wakes up from surgery! The surgery also helps lower blood pressure and cholesterol levels, reducing the risk of cardiovascular disease. 

Gastric bypass surgery has been shown to improve mental health and quality of life. Many patients report an increase in self-esteem and a reduction in depression and anxiety symptoms following surgery. The improved physical health and body image contribute to an overall sense of well-being and improved psychological well-being. 

Preparing for gastric bypass surgery 

Preparing for gastric bypass surgery involves several important steps to ensure a successful procedure and smooth recovery. Before the surgery, you will undergo a thorough evaluation with your BodyByBariatrics comprehensive team! 

To prepare for surgery, we will guide you through a preoperative diet and lifestyle changes. This includes minimizing your total net carbs to reduce liver size and improve surgical outcomes.  

We review all your medications and supplements, as some may need to be adjusted or temporarily stopped before and/or after the surgery. Additionally, you will receive instructions about fasting before the procedure and what to expect on the day of surgery.

CLICK HERE for a sneak peak of our BodyByBariatrics Bariatric Surgery Success Guide found on our Resources page 

The gastric bypass procedure explained 

The gastric bypass procedure typically takes just under one hour to perform.

The patient is positioned on the operating table in a supine (lying face up) position. Sequential compression devices (SCDs) are placed on both lower extremities to prevent blood clots. Antibiotics are administered intravenously by the anesthesia team to prevent infection.

The patient undergoes general endotracheal tube anesthesia (GETA), meaning they are fully asleep and unaware during the surgery. A Foley catheter, a tube inserted into the bladder to drain urine, is NOT placed. 

The abdomen is prepped and draped in a sterile manner. Four small incisions (three are 5-mms and one is 10-mm) are made in the abdomen. Through these incisions, trocars (hollow tubes) are inserted to create ports for surgical instruments and a camera. 

Dr. Dovec and Dr. Lane begin by creating a connection between two parts of the small intestine called the jejunum. This anastomosis is called the jejunojejunostomy. This bypasses a portion of the intestine, reducing the absorption of calories and nutrients. 

We then divide the stomach to create a smaller pouch (about the size of a thumb), limiting the amount of food that can be eaten at one time.  

We connect the newly created thumb sized stomach pouch to the jejunum, completing the bypass. This allows food to bypass the majority of the stomach (~95% is bypassed) and the first part of the small intestine, resulting in reduced calorie absorption. 

We ensure that all connections are secure and free from leaks. An instrument called a Visigi is used to check for leaks by insufflating air into the digestive system and observing for bubbles. The incisions are closed with sutures with a subcuticular (“plastic surgery”) closure.  

After the surgery, the patient is monitored closely in the recovery area to ensure there are no immediate complications. Pain medication and instructions for postoperative care are provided. 

Patients undergo regular follow-up appointments with us to monitor progress, adjust medications, and address any concerns. At BodyByBariatrics, we are always available via text (407-543-0971)!  

Recovery and post-operative care 

Recovering from gastric bypass surgery requires commitment and adherence to specific guidelines to ensure a successful outcome. During the initial weeks after surgery, you will follow a diet progression of full liquid to pureed diet to soft and ultimately regular foods to allow the stomach to heal. We gradually reintroduce solid foods. 

Pain and discomfort are common after surgery, but we provide medications to manage this. It feels like gas pressure and incisional soreness. We will set your expectations.  

Great news – it works! 

Gastric bypass surgery has transformed the lives of countless individuals struggling with obesity. The success stories and testimonials of those who have undergone this procedure are a testament to its effectiveness. Check out our BodyByBariatrics Instagram page to see the results! 

Listen to our full DoctorXDietitian episodes on the Bariatric Basics and the Gastric Bypass! 

XOXO,
BodyByBariatrics 

*BodyByBariatrics blog does not replace medical advice. Seek the help of your health care professional if you have questions related to your condition. We strive for patients to achieve healthier, happier, longer lives through weight loss surgery. 

 

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