Roux-en-Y Gastric Bypass
Dr. Justin Greenslade’s practice offers a suite of advanced general surgical procedures tailored to your needs.
What is Roux-en-Y Gastric Bypass?
Laparoscopic Roux-en-Y Gastric Bypass (RYGB) is a well-established bariatric procedure commonly used for weight management. The operation involves creating a small gastric pouch of about 50ml and connecting it to a section of the small bowel (the jejunum), so that food bypasses most of the stomach. It is not a pancreaticobiliary or intestinal bypass.
The operation is widely used because:
It can result in significant and sustainable weight loss in most patients. Median weight loss at 12 months is 60-70% of a patient’s excess weight.
Approximately 50% excess weight loss is maintained after 15 years post-operatively.
As a consequence of the weight loss, there is a reduced risk of obesity-related complications such as diabetes, lipid abnormalities, sleep apnoea, etc.
Currently, it is the only operation that has been shown to reduce mortality in the morbidly obese.
The operation can be done at an acceptable mortality (0.5-1.0%) in this high-risk group. Morbidity is low with few post-operative side-effects and few nutritional deficiencies.
Quality of life is generally good with minimal gastrointestinal side effects. Macronutrient absorption remains normal, though micronutrient deficiencies (such as B12, calcium and iron) may occur and require ongoing supplementation.
How does the gastric bypass work?
Weight is lost by the following 4 mechanisms:
1. Early fullness is induced by the small gastric pouch.
2. Over-eating is prevented by the small pouch. Too much food causes discomfort and regurgitation.
3. Patients may become intolerant to sweets as the rapid presence of sugar in the small bowel leads to unpleasant symptoms called “dumping”. Hence, there is a tendency to avoid sweet and fatty foods.
4. Most importantly, the operation results in suppression of appetite. This is thought to occur due to the rapid entry of foods into the small bowel which evokes a hormonal effect that induces satiety.
It is thought that a similar hormonal response is responsible for the 75% cure rate of Type II Diabetes following gastric bypass.
What is life like with a gastric bypass?
You will likely experience less hunger and also feel satisfied after eating small meals. The amount of food you eat is approximately a quarter of your previous diet. When dining out at a restaurant, you can generally eat an entrée-sized meal and feel content The key point being that a small meal is enough, hence the experience is different from dieting and therefore supports sustainable long-term changes.
Sweets and fatty foods are generally poorly tolerated and best avoided. These foods will likely cause “dumping” due to the rapid presence of high osmolality fluid in the small bowel. Symptoms are nausea, dizziness, palpitations, sweating and abdominal discomfort.
To avoid dumping, high sugar and high fat content foods should be avoided, and food should be eaten dry and not mixed with fluids. You will also need to avoid snacking, especially with junk foods, as this will negate the effects of the surgery. Apart from a commitment to healthy eating, no other foods are specifically banned.
Multivitamins and calcium supplementation must be taken daily by all gastric bypass patients. Vitamin B12 and iron supplements are also recommended. These are lifelong requirements to support good health.
Start your weight loss surgery journey with Brisbane Bariatric Centre today
If you’re thinking about weight loss surgery or just want to know what’s possible, we’re here to help. Get in touch to book a chat with Dr Justin Greenslade and find out what’s right for you.
