Roux-en-Y gastric bypass (RYGB) surgery

What is a Roux-en-Y gastric bypass surgery?

Roux-en-Y gastric bypass (RYGB) is a type of weight-loss surgery that reduces the size of the patient's 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 eat during 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 the patient absorbs from the foods they have eaten and further increases weight loss.  

What happens during Roux-en-Y gastric bypass?

Roux-en-Y gastric bypass can be done as an open surgery, with a large cut (incision) on your abdomen to reach your stomach. Alternatively it can be done laparoscopically (keyhole), using a lighted tube with a tiny camera, called a laparoscope. This tool is inserted 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.

What is the recovery like?

You will have some stomach pain and may need pain medication for the first week or so after surgery.

You may stay in the hospital for two to four days after the procedure. You will typically only have liquids or pureed foods for at least three to six weeks after surgery. Rarely, you may have a catheter, or tube, from the larger bypassed part of your stomach.

A catheter or tube will come out of your side and will drain your abdomens excess fluids for four or more weeks depending on your recovery.

What are the possible complications?

Like any surgery, the Roux-en-Y gastric bypass procedure carries some risks:

• Internal bleeding
• Infection
• Potentially life-threatening blood clots in the legs that can travel to the heart and lungs
• Respiratory problems
• Leaks from internal incision sites
• Death.

Long-term complications related to Roux-en-Y gastric bypass surgery may include: 

• Malnutrition, especially if you don't take your prescribed vitamins and minerals daily for the rest of your life
• Iron and calcium deficiencies
• Gastric "dumping," which can cause nausea, rapid heartbeat, flushing, fainting, and other unpleasant symptoms such as diarrhoea after eating
• Narrowing of the sites where intestines are joined (stricture)
• Staple-line failure, where the pouch was created
• Dangerous internal hernias in which the intestine can be trapped and blocked
• Need for additional operations because of problems such as a stretched pouch or separated stitches
• Failure to lose enough weight if you snack on high-calorie foods and don't exercise.