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Roux-en-Y gastric bypass (RYGB) is a type of weight-loss surgery that reduces the size of your stomach to a small pouch – about the size of an egg. It does this by stapling off a section of it. This reduces the amount of food you can take in at meals. The surgeon then attaches this pouch directly to the small intestine, bypassing most of the rest of the stomach and the upper part of the small intestine. This reduces the amount of fat and calories you absorb from the foods you are able to eat for even more weight loss.
RYGB can be done as an open surgery, with a large cut (incision) on your abdomen to reach your stomach. Or it can be done as a laparoscopic RYGB, using a lighted tube with a tiny camera, called a laparoscope. This tool is pushed into your abdomen through several small cuts. Your doctor may prefer to do a laparoscopic procedure instead of open surgery because it generally means you don’t stay in the hospital as long and recover more quickly. You also may have less pain, smaller scars, and less risk of getting a hernia or infection. Many people are able to have this procedure done laparoscopically.
Obesity lowers quality of life. This can result in poor overall health, and contribute to a higher risk for depression. Your doctor may suggest a RYGB surgery if you have a body mass index (BMI) of 40 or more or if you have a BMI of 35 and also have serious obesity-related health problems such as diabetes, heart disease, sleep apnea, high blood pressure, or severe arthritis.
Doctors generally recommend the weight-loss surgery only if you are severely obese. That means about 100 pounds overweight for men and 80 pounds for women and if you are unable to lose a large amount of weight and keep it off through diet, exercise, and lifestyle changes.
Calculate your body mass index.
Studies on RYGB have found that it can often reverse type 2 diabetes and lower the risk for high blood pressure, sleep apnea, and certain heart problems.
Like any surgery, the RYGB procedure carries some risks:
Long-term complications related to RYGB surgery may include:
There may be other risks, depending upon your specific medical condition. Be sure to discuss any concerns with your doctor before the procedure.
It’s important that your weight-loss surgery be arranged at a qualified bariatric center, where you will complete an extensive educational and preparatory program before surgery.
With either open or laparoscopic RYGB surgery, you will be given general anesthesia for the procedure. Initially your doctors will start an IV and may deliver medications to help you relax. Your anesthesiologist will use a drug or combination of drugs to control pain and make you unaware of the procedure.
When you reach the operating room, your medical team will use routine monitoring equipment throughout the procedure or longer, depending on your health conditions.
The surgery to create the stomach pouch and the bypass usually takes several hours.
You may stay in the hospital for 2 to 4 days after the procedure. You will typically only have liquids or puréed foods for at least 3 to 6 weeks after surgery. Rarely, you may have a catheter, or tube, from the larger bypassed part of your stomach that will come out of your side to drain excess fluids from your abdomen for 4 or more weeks.
Your doctor may slowly add soft food and then regular food to your diet about a month after surgery. You will be instructed to chew slowly and completely and not to drink 30 minutes before or after you eat food.
Talk with your doctor about proper wound care, the type of pain-relieving drugs that are safe to take, and when you can resume physical activities. Your surgeon will tell you how often to change the dressing on your incision.
Tell your doctor right away if you develop a fever or if your wound becomes painful or hot to the touch or has a foul-smelling drainage. Also look for any coughing or difficulty breathing, vomiting and diarrhea, pain in the abdomen, chest, shoulder, or legs, or any other unusual symptoms.
Your initial weight-loss may occur quickly, so it's important to get all of the nutrition and vitamins you need as you recover. Your doctor will prescribe certain vitamin and mineral supplements that your body may no longer absorb well from food alone.
The following supplements are recommended to prevent nutritional deficiencies after recovery from RYGB surgery:
You may have body aches, dry skin, mood changes, and temporary hair thinning and loss during this time, as well as feel tired and cold. As your weight stabilizes, these problems should go away. Know that weight loss may slow down after the first year, so prepare yourself mentally for the fact that eventually the weight loss will stop.
Along with follow-up appointments with your doctor and surgeon, you will likely see a nutritionist or dietitian who will teach you how and what to eat with your reduced stomach size. You may also need to visit with a psychologist to help you deal with the feelings and concerns over your changed lifestyle.
Because nutritional deficiencies are so common after this surgery, experts recommend that your blood be tested every 6 months for the rest of your life to ensure that you are getting the right amount of vitamins and minerals.
Before you agree to the test or the procedure make sure you know:
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