Bariatric Surgeries (Gastric Sleeve)

3. Roux-en-Y gastric bypass (RYGB)

Roux-en-Y gastric bypass is a well-known bariatric surgery that was performed in the 50s. Gastric bypass is called roux-en-y procedure because it was first described and demonstrated by a Swiss doctor called dr. Cesar roux and the letter “Y” resemble the shape of the gastrointestinal tract after the surgery. Gastric bypass simply involves modifying the tract in which the food passes by bypassing the stomach and the duodenum that most of the food is absorbed.

What is the process of gastric bypass? Gastric bypass operation takes approximately 1.5 hours and it goes as follows: firstly the bariatric surgeon will cut a small upper portion of the stomach and sew its free end to make a pouch. Then an intestinal transection is made at the level of the jejunum dividing the intestine into two parts. The surgeon connects the lower part of the intestine to the small pouch he made out of the stomach. Finally, the rest of the stomach and the upper part of the intestine is connected to the new gastro-intestinal tract to secrete their digestive juice in it.

Statistics showed that gastric bypassing is the second most common bariatric surgery after gastric sleeve. Surgeons often favor gastric bypassing over gastric sleeve for diabetic patients because rerouting the passage of food is found to improve diabetes mellitus. According to ASMBS (American Society for metabolic and bariatric surgery), about 40,000 gastric bypass operations are performed in the US in 2019.

Gastric bypass has significant results as patients are believed to lose up to half of their weight within six months after having it. It is believed that gastric bypassing not only restricts food consumption and reduces food absorption but also regulates hormones secretion resulting in rebooting the brain’s sense of fullness. Patients who underwent gastric bypass feel fewer cravings for food.

Although gastric bypass surgery is remarkably effective it has some disadvantages that obese patients should be aware of. First of all, Gastric bypass costs much more than other bariatric operations as the average cost of it is about 24,000 dollars. Pricing of the operation varies according to where you will have the surgery so make sure that your insurance will cover part of the expenses.

It is believed that gastric bypass is more aggressive and invasive than other bariatric options, therefore it exposes the patient to more risks. Mal-absorption and nutritional deficiency are frequent complaints from patients who had the surgery, yet they could be treated with supplements.

Recovery duration after gastric bypass may be longer than other bariatric options. It is reported that patients may complain about mild to moderate symptoms after surgery such as nausea, vomiting, abdominal cramps, discomfort, and abdominal pain. Patients who had bypass surgery should follow up with a dietitian regularly to discuss their options in their diet and to assess the results.