Roux-en-Y Gastric Bypass

How is it done?

Roux-en-Y gastric bypass.

A gastric bypass combines the effects of restriction and malabsorption. Restriction is created by making a small pouch. This is done by sectioning off the top portion of your stomach with a triple staple line. A new opening is then created from this small pouch.

The malabsorption effect is achieved by bypassing the first segment of your small intestine. The remainder of your small intestine is then joined to the new opening from your stomach pouch.

The remainder of your stomach, which is now redundant, remains quite happy inside you.

Risks and side-effects

A gastric bypass operation is a major surgery with permanent changes made to your digestive tract. Therefore the risks and benefits need to be weighed up carefully before a decision is made to proceed.

• Due to sectioning and joining, a lot of internal stitches and staples are in your stomach and intestines. One of these seams could leak, requiring on some occasions a return to theatre in the first few days for a second operation to repair it.
• As your digestive tract has been altered, it is prone to strong reactions to the food you eat. You need to allow your body time to adapt to your new digestive pathway.
• 'Dumping' may be caused by eating too much sugar or fat.
• Longer term effects such as stomach pouch dilation or tightening of the stoma (opening) between your stomach and intestine need remedial surgery. These experiences are quite rare, particularly once everything has settled down after surgery.
• As your food absorption has altered, you will need to take multi-vitamin supplements daily. We also regularly check your blood for vitamin and mineral levels to ensure you do not develop any deficiencies. Sometimes additional supplements may also be required.
• Despite all the best management, a small number of people will still fail to lose weight with a gastric bypass. Further modifications to increase the amount of malabsorption are possible, however raise the risk:benefit ratio significantly and are not undertaken lightly.
• As with all major surgery the risk of death is a consideration. The major cause of death with this surgery is the development of blood clots in your lungs (Pulmonary embolism). To reduce this risk, we supply blood-thinning medication before and after surgery. We also encourage ambulation and sitting out of bed as soon as possible after surgery. Compression stockings must also be worn after the operation until normal activity is resumed.

Post-operation diet advice

The changes to your digestive system mean that you will need to follow a specific diet. A dietician will see you before you are discharged from hospital to assist you with the changes needed for your new lifestyle.

• Eat small, frequent meals at least six times per day.
• Everyone tolerates foods differently. Avoid those foods known to cause you problems.

Dumping syndrome
When food or fluids move too quickly through your digestive system, it’s called 'dumping syndrome'. Symptoms of dumping syndrome are:

• Nausea
• Dizziness or light-headedness
• Weakness and fatigue
• Rapid pulse
• Abdominal cramping
• Diarrhea

Tips to help avoid dumping syndrome

• Don’t drink liquids with your meals. Wait a half to one full hour after eating food to drink something.
• Limit sweets. Use sugar-free foods and drinks in place of regular sweet foods or drinks.
• Lactose (milk sugar) may also cause diarrhea and cramping. Drink lactose-free or lactose reduced milk.
• Avoid carbonated drinks and alcohol.
• Eat slowly and chew your food carefully.

Special note:
A multi vitamin should be introduced to your diet before your operation, and you will need to continue this after your operation. To ensure you are meeting all your vitamin dietary requirements (B12 etc), you should also have blood tests taken six monthly.

More information

All of the information you need to know, pre and post-operatively, will be made available to you in separate information packs given to you before and after your surgery. Our practice nurse, Kylie, will also be able to assist you with any questions that you might have at any time.

Consent form

You are required to fill out a consent form prior to Gastric Bypass surgery. You can obtain a form from our clinic or download the consent form and print it out yourself.