Roux-en-y Gastric Bypass (gastric Bypass - Gb)

It can be performed through open surgery or by laparoscopic approach. During the surgery, the stomach is divided into two parts: a small “pouch” (egg-sized) and a large part. After that, the small intestine is divided and a part of it is reattached to the pouch and the other part to the intestine itself. The weight loss occurs because the ingested food bypasses a large part of the stomach and a part of the small intestine.

How does it work?

The surgery consists of two components:

• Creating a small stomach pouch (15-30 mL) by surgically dividing the top (thumb-like in size) stomach from the remaining lower part. The division can be absolute or a “wall” could be created between the 2 parts of the stomach.
• Next, the small intestine is divided (approximately 45 cm below the stomach) and re-arranged into a “Y” configuration. The bottom end of the divided small intestine is brought up and connected to the small stomach pouch, while the top portion is connected to the small intestine further down. The ingested food bypasses the remaining lower part of the stomach and the top part of the small intestine. This way it is not digested by the bile and pancreatic juice that is normally secreted into the duodenum (the top part of the small intestine), and the digestive enzymes eventually mix with the food in the lower part of the small intestine.

What are the risks?

• Infection;
• Bleeding;
• Blood clots;
• Gastritis (stomach inflammation) or gastric ulcers;
• Injury to the stomach or small intestine during the surgery;
• Leaks from the separated parts of the stomach;
• Poor nutrition.

How to prepare for the procedure?

• Perform specific Lab tests for medical evaluation, a common step before any type of surgery;
• Your doctor may advise you to take an ultrasound of your internal organs to see if you don’t have any medical conditions that could complicate the surgery.
• The use of anticoagulant and anti-inflammatory medication should be ceased 2 weeks before the surgery (to prevent bleeding).
• It is recommended to stop smoking for about 2 months before surgery.
• The night before the surgery your dinner should be light and no later than 18.00 o’clock. On the day of the surgery is not advisable to eat or drink anything.
• You should follow your doctor’s instructions for the pre-surgery diet. It will be consistent mostly with liquid meals.

How long does the procedure take?

The surgery lasts about 60 to 90 minutes. For the laparoscopic approach, you will need 2-3 days of hospital stay, while for the open surgery 3 - 4 days longer.

How to recover after the procedure?

• The first days after surgery you will need to monitor your hydration level;
• Regular walking is recommended but avoid heavy exercise and weight lifting;
• The most important part of postoperative recovery is maintaining a strict diet. The surgeon should give you the exact instructions on particular foods to eat. The diet will start with liquid meals, continue with soft ones and finish with solid food.
• There will probably be a need for vitamin and nutrient supplements for the rest of the patient’s life. These will help avoid severe conditions caused by the poor absorption of essential elements, caused by the bypass.
• Follow-up visits with your doctor are a must.

Those interested in patient experiences can find valuable insights in the Patient Story: Bariatric Surgery Transformation.

If you want to explore more options, take a look at our list of Bariatric Surgery Packages from various clinics.