Roux-en-Y gastric bypass, often called gastric bypass, is considered the "gold standard" of weight-loss surgery. It is a type of bariatric surgery consisting of two components: first, a small stomach pouch, approximately one ounce or 30 milliliters in capacity, is created by dividing the upper part of the stomach from the rest of the stomach; then, the small intestine is divided, and the lower end of the divided small intestine is elevated and connected to the newly created small stomach pouch. The procedure is completed by connecting the upper portion of the divided small intestine to the lower small intestine so that the acid and digestive enzymes from the excluded stomach and the first portion of the small intestine eventually mix with the food.

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How does it work?

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The newly created stomach pouch is smaller and can hold less food, meaning fewer calories are ingested. Additionally, food does not come into contact with the first portion of the small intestine, resulting in decreased absorption. More importantly, modifying the flow of food through the gastrointestinal tract has a profound effect on decreasing hunger, increasing satiety, and allowing the body to reach and maintain a healthy weight. The impact on hormones and metabolic health often results in an improvement in diabetes even before weight loss occurs.

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Advantages

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• Produces significant long-lasting weight loss (60–80% excess weight loss).

• Effective for remission of obesity-associated conditions.

• Helps patients with reflux, and symptoms often improve rapidly.

• Restricts the amount of food consumed.

• Can lead to conditions that increase energy expenditure.

• Produces favorable changes in gut hormones that reduce appetite and improve satiety.

• Typical maintenance of excess weight loss greater than 50 percent.

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What to expect?

 

• After bypass surgery, patients can expect to lose about one-third of their total body weight. The maximum weight loss effect is typically seen within the first year, and most patients maintain a healthy body weight long-term.

• In addition to weight loss, several obesity-related conditions often improve after surgery. These include type 2 diabetes, hypertension, dyslipidemia, metabolic syndrome, fatty liver disease, and obstructive sleep apnea.

• More than 50% of diabetic patients will experience normalization of their blood glucose levels and will stop taking medications or insulin injections.

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* Atlas of Bariatric and Metabolic Surgery of The International Federation for the Surgery of Obesity and Metabolic Disorders (IFSO)