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Roux-en Y gastric bypass or gastric bypass is an established surgical treatment for morbid obesity. This is usually performed with laparoscopy or “key-hole” surgery. It involves partitioning the stomach into a small pouch and re-arranging part of the small bowel. The small stomach pouch, about the size of one’s thumb, is fashioned with a surgical stapler and separated from the remainder of the stomach. The upper half of the small bowel is sectioned and re-arranged into 2 limbs – Roux or the ‘food’ limb and biliopancreatic or “ digestive enzyme” limb. The “food” limb is then connected to the small stomach pouch to restore the continuity of gut and the “digestive enzyme” limb connected to the “food” limb downstream to allow digestion of food and absorption of nutrients in the “common” limb. With gastric bypass, patients feel full and satisfied with a small portion of food. In addition, the re-arrangement of the small bowel triggers hormonal changes that suppresses hunger and improves diabetes.
The advantages of gastric bypass are:
With gastric bypass, patients can lose 60-80% of their excess body weight.
Weight loss
You would lose most weight in the first 6-9 months and it will slow down after 1-1.5 years before plateauing.
Heartburn
It should resolve immediately after surgery. However you will continue anti-acid medication for 4 weeks after surgery to help with healing of gastric wound.
Diabetes
There will be immediate improvement of blood sugar level after surgery due to hormonal changes in the body that stimulates the release of insulin. Your blood sugar level will be closely monitored and medication may need be adjusted or reduced accordingly. With further weight loss, your diabetes may continue to improve or resolve completely.
Yes, long-term follow up is mandatory.
6 to 12 monthly nutritional surveillance with blood tests to ensure adequate nutritional health.