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What is Roux-en-Y Gastric Bypass surgery (Bariatric Surgery)?

Updated on August 11, 2014
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Jacqui is an RCompN in NZ, with 16+ years of experience. She writes on a number of health topics that she has experience in.

Roux-en-Y Gastric Bypass

Roux-en-Y Gastric Bypass
Roux-en-Y Gastric Bypass | Source

Weight Loss Surgery

In today's modern world, there are numerous ways to lose excess weight. Tried and true diet groups like Jenny Craig, Weight Watchers, new and old fad diets that do work for some - Atkins, Dukan, Eat Your Type etc. And there are also surgeries - Gastric Sleeve, Lap Band, Gastroplasty, and the Roux-en-Y Gastric Bypass.

It is this final surgery I will be talking to you about today. I have personal experience of this particular surgery myself, so I will also be providing a personal account of this surgery.

Last Resort?

For many - Surgery for weight loss is a last resort. Diets haven't worked, health issues are becoming a problem that can no longer be ignored. Most of these surgeries cannot be reversed so it is prudent that these surgeries are only considered after nothing else has worked.

For many, particularly those who may struggle with weight but haven't 'resorted' to surgery, it may seem like cheating - a band to make you feel full "just don't eat as much" etc. My own sister commented that it was 'cheating' to have surgery to my mother who has had a gastroplasty herself who corrected her promptly. It is not a way to 'cheat'. It is more a 'tool' to assist you in your weight loss. Like any other tool, if it is used incorrectly, it will not work as designed.

Roux-en-Y Gastric Bypass is a non-reversable 'tool'. After a very thorough work up - in NZ this can include pyschologists, dieticians, surgeons etc and they all have to agree - you are booked for surgery. How exciting!

Laproscopic Surgery

Public Domain (Wikipedia)
Public Domain (Wikipedia) | Source

Surgery

Roux-en-Y Gastric Bypass can be done either laproscopically (keyhole), or open. My personal experience is with keyhole surgery.

After popping you off to sleep, and achieving access in which ever way was chosen to be safest for you, they then section off the stomach into two pieces - a 'pouch', and the rest of your stomach.

The 'pouch' is the top 1/4 (approx) of your stomach which is attached to your oesophagus. This pouch will now be your stomach. It contains the nerve endings that signal to your brain that you are full - so now, when you eat these are trigger MUCH faster than they used to be.

The other part of your stomach, and much of your duodenum are removed from your intestine - and repositioned elsewhere onto your intestine. This is because the stomach still makes 'intrinsic factor' - a factor needed to assist you in absorbing Vit B12 amongst others. This often gurgles after surgery - I know I personally gurgle from the left hand side of my abdomen which is where this is now located.

The remaining length of the intestine is then attached to the bottom of the pouch, creating the bypass of the stomach. Most surgeons use titanium staples for sealing, or securing these. Don't worry - you will not set off the alarms in Customs. This is also true for places such as the USA - I passed through many a metal detector and never set them off.

Afterwards

After recovering from the surgery - where you'll be surprised at just how little you can manage - there are a few changes you need to make.

Dumping Syndrome - this refers to a nasty experience you will likely have at least once - after eating sugar, fat, or carbs you suddenly feel nauseous, tired, maybe feel like you need to go to the bathroom (Number 2s!). Or sometimes, the shakes like you are hypogylcaemic.

Personally I found that I can eat a certain amount of sugar and anything more than this, I have nausea, tiredness almost immediately (occasional vomiting if I was really off on how much sugar I thought I'd had!). After a lot of fats - stomach ache about 30mins after eating it. With carbohydrates I tend to get a hypogylcaemic episode feeling about 2hrs later. It is tempting with the hypo feeling to eat and eat until it goes away - learn what you need maybe a muesli bar, or 2 biscuits - and wait - it will go. The other dumping effects do go too. I promise.

Some people (such as my uncle) are lucky enough not to have any of these! I get all three.

Vitamins

Wikipedia (CC BY-SA 3.0)
Wikipedia (CC BY-SA 3.0) | Source

Vitamins -The weight loss with a Roux-en-Y is due to 'malabsorption" as well - so you will need to be on vitamins - Iron, Folic Acid, Calcium, Vit B12, Multi-vitamins, and occasionally Vit D as well - for life. It's not difficult, and it's a whole lot better than the alternative.

NOTE: For those who are female, and of reproductive age - you will need to increase your Folic Acid to 5mg tabs from 0.8mg to avoid Spina Bifida type complications for your baby. You also need to be very vigilant about taking your vitamins - you will be able to eat enough for the two (or more) of you, but due to not absorbing as well as you should - the vitamins are helpful for both you and baby.

Meal Size -Strangely enough - this can vary from time to time - one day you may be able to eat a reasonably amount, the next - not much at all.

Drinking with meals/Finishing in time -My surgeon recommended not drinking with a meal - it pushes food through and makes it so you can eat more which defeats the purpose of your surgery. Also, after approximately 20mins - stop eating. Your body will have begun to process your food, and will be making more room, again defeating the purpose.

Alcohol?

Public Domain (Wikipedia)
Public Domain (Wikipedia) | Source

Alcohol - You will be a cheap drunk! Be careful. Do not go out and go drinking straight away in the same fashion that you used to. If you wish to drink alcohol, start slowly. Trial at home first. If you don't follow this, you may run into trouble - passing out etc - even on MUCH less than it used to take - I've never passed out until after surgery and I don't drink much at all. Just be careful

IMPORTANT NOTE RE: ALCOHOL - You may feel completely sober very quickly after a drink - it may go straight to your head, due to rapid absorption in your gut post surgery. After 15mins or so, you may not feel any effects. Now, I do not recommend driving after drinking - even after a few. However, if you are someone who usually drives after one or two - be careful - you may feel as though you've only had a few, even after a few more than that - you will feel sober - you will likely blow over the limit, and you will definitely test (via blood) over the limit. BE CAREFUL.

Otherwise, after 9 yrs I have no regrets - I would do it again in a heartbeat. Any questions - please ask - I'm happy to help out!

Good Luck!

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