RNY bypass is the gold standard of bariatric procedures. In the Roux-en-Y gastric bypass procedure, surgery is performed on the stomach (as in the gastric sleeve) and the small intestine (the part of the digestive system where nutrients are absorbed).
The coronavirus pandemic increased patients’ emotional distress and difficulty adhering to a healthy diet. That is why gastric bypass regained some of its popularity after COVID.
What is a Gastric Bypass?
It consists of making a smaller stomach and then connecting it with the intestine. By doing this surgery, we help our patients to eat less (feel satisfied with less food) and decrease the absorption of food.
How Gastric Bypass Surgery Works
Roux-En-Y or (RNY) gastric bypass is the most common bariatric surgery performed in the United States. Roux-En-Y gastric bypass is often used in order to help patients who need assistance with initial weight loss and as a method for long-term weight control.
Dr. Christian Rodriguez Lopez uses a bougie size of 32F or .40 inches in diameter for gastric bypass surgery.
Why Do You Lose Weight with Gastric Bypass?
The human body’s normal digestive process involves food moving through the digestive tract and combining it with enzymes and digestive juices, which help bodies digest food and absorb nutrients and calories.
RNY gastric bypass enhances the level of gastrointestinal hormones like the active GLP-1 and total PYY.
The average human stomach can hold about three pints of food at a time, and excess is released slowly into the small intestine. Once in the small intestine, the body absorbs vitamins, nutrients, and minerals. It can take several hours for the stomach to empty into the small intestine.
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Gastric Bypass Surgical Steps
Roux-En-Y or (RNY) gastric bypass procedure is utilized by people who are clinically diagnosed to be obese. The surgical process is minimally invasive but can still pose complications for patients undergoing the procedure. A large incision is made in the abdomen, or the surgery can be done using a small incision and employing a camera and small instruments to perform the procedure.
The Roux-En-Y gastric bypass procedure restricts or limits food intake into the stomach. A small gastric pouch is created using surgical staples or a plastic band device.
A Roux-En-Y gastrojejunostomy provides a mild malabsorptive component that prevents the full absorption of excess nutrients and calories into the body. The stomach’s smaller pouch is then connected directly to one’s small intestine to bypass the rest of the stomach.
Once the stomach is made smaller and food is directly bypassed into the small intestine, patients will feel their stomachs are full quicker than if the stomach was its original size. Since the amounts of food products that can be consumed are limited, the number of calories going into and being absorbed by the body is much less. This is why, shortly after surgery, weight loss results can be seen and felt by patients.
Do I Qualify for RNY Gastric Bypass?
Starting at $5,795
In order to qualify for Roux-En-Y gastric bypass surgery, there are some typical requirements most patients will have to meet first. The typical criteria include:
- A patient’s body mass index should generally be 40 or over, or they need to have a disabling or life-threatening condition caused by excessive weight.
- Most physicians prefer to try other types of weight loss/reduction programs first and will use a gastric bypass as an alternative when other methods do not work.
- Patients should be obese for 5 years or more and are between the ages of 18 and 65.
- Patients should also not have medical histories containing incidents of depression, psychiatric disorders, or alcoholism.
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Pros and Cons
Like all surgical procedures and weight loss solutions, there are advantages and disadvantages for patients, and not all individuals will be good candidates for all weight loss procedures like Roux-En-Y gastric bypass.
Advantages of Gastric Bypass
Compared with other types of weight loss surgery, Roux-En-Y gastric bypass surgery is excellent for overall weight loss and long-term weight control of patients. It has also been proven to be effective in eliminating co-morbidities, such as Type 2 diabetes.
This surgical procedure also has low rates of complications in both the early and late stages following surgery, as well as very low (less than 1%) mortality rates in patients undergoing the procedure.
Disadvantages of Gastric Bypass
Like any surgical procedure, risks are involved during the actual surgery and afterward during recovery. Surgical risks include those associated with undergoing anesthesia and allergic reactions to medicines. The complications stemming from the surgery itself include leaks, distension of the stomach, hernias, and severe dumping syndrome symptoms.
Most patients that do not experience significant surgical complications often see fast weight loss initially and will continually lose pounds quickly for a period of up to a year. However, diet and exercise need to be considered for successful ongoing weight loss after surgery is completed.
Severe dumping syndrome is a direct result of gastric surgeries. Multiple symptoms may occur that range from mild to severe. They are caused by having the undigested contents of your stomach dumped into your small intestine too quickly, causing nausea and abdominal cramping.
Some patients will experience symptoms right after eating, and some will not have symptoms for several hours after consuming food. In most cases, medical intervention is not necessary for treating dumping syndrome symptoms, but more severe cases may require medication or additional surgery.
Another disadvantage of Roux-En-Y gastric bypass surgery is that the procedure itself is often more challenging than other types of restrictive bypass procedures. However, individual patients’ health and medical history must be considered case-by-case.