Roux-en-Y Gastric Bypass -- Open Surgery
(Bariatric Surgery; Weight-Reduction Surgery)
- Restricting food intake—creates a small pouch to serve as the stomach, so you cannot eat as much
- Making the body unable to absorb as many calories from the food—bypasses the first part of the small intestine, where many of the calories from food are usually absorbed
Reasons for Procedure
- BMI greater than 40
- BMI 35-39.9 and a life-threatening condition or severe physical limitations that affect employment, movement, and family life
- Long-term weight reduction
- Improvement in many obesity-related conditions
- Improved movement and stamina
- Enhanced mood, self-esteem, and quality of life
- Blood clots
- Hernia formation
- Bowel obstruction
- Breakdown of the staples, allowing leakage of stomach juices into the abdomen
- Diarrhea, abdominal cramping, and vomiting
- Dumping syndrome—This occurs after eating sweets, when food moves too quickly through the small intestine causing sweating, fatigue, lightheadedness, cramping, and diarrhea
- Complications of general anesthesia
What to Expect
Prior to Procedure
- Thorough physical exam and review of medical history
- Ongoing consultations with a registered dietitian
- Mental health evaluation and counseling
Talk to your doctor about your medications, herbs, and dietary supplements. You may be asked to stop taking some medications up to one week before the procedure, such as:
- Anti-inflammatory drugs
- Blood thinners
- Do not start taking any new medications, herbs, or supplements without talking to your doctor.
- Arrange for a ride to and from the hospital.
- Arrange for help at home as you recover.
- You may be asked to take antibiotics before coming to the hospital.
- You may be asked to take laxatives and/or do an enema to clear your intestines.
- The night before your surgery, eat a light meal. Do not eat or drink anything after midnight unless told otherwise by your doctor.
- Shower or bathe the morning of your surgery.
Description of Procedure
|Roux-en-Y Gastric Bypass|
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How Long Will It Take?
How Much Will It Hurt?
Average Hospital Stay
- Pain medication will be given as needed.
While in the hospital, you may be asked to do the following:
- On the day of surgery—You will not be given food or drinks.
On the day after surgery—You will have an
to check for leaks from the stomach pouch. For this test, you will drink a special liquid while x-rays are taken.
- If the upper GI x-ray is normal, you will be given 30 milliliters (mL) of liquids every 20 minutes.
- If leaks are found, you will receive nutrition through an IV until the leaks are fixed.
- On the second day after surgery—You will take 1-2 tablespoons of pureed food or 1-2 ounces of liquids every 20 minutes.
- Use an incentive spirometer to help you take deep breaths. This helps prevent lung problems.
- Wear elastic surgical stockings or boots to promote blood flow in your legs.
- Get up and walk daily.
- Washing their hands
- Wearing gloves or masks
- Keeping your incisions covered
- Washing your hands often and reminding visitors and healthcare providers to do the same
- Reminding your healthcare providers to wear gloves or masks
- Not allowing others to touch your incision
- Ask your doctor about when it is safe to shower, bathe, or soak in water.
- You may be out of work for 2-6 weeks after gastric bypass surgery.
- Do not drive or lift anything heavy until your doctor tells you it is safe. This may be up two weeks or more.
- Walk as soon as possible, with a goal of exercising daily.
- You may have emotional changes after this surgery. Your doctor may refer you to a therapist.
- You will meet regularly with your healthcare team for monitoring and support.
- You will begin with 4-6 meals per day. A meal is two ounces of food.
- For the first 4-6 weeks after surgery, all food must be pureed.
- When you move to solid foods, they must be chewed well.
- When making food choices, you will need to consume enough protein.
- Avoid sweets and fatty foods.
- Eating too much or too quickly can cause vomiting or intense pain under your breastbone. Most people quickly learn how much food they can eat.
Call Your Doctor
- Signs of infection, including fever and chills
- Redness, swelling, increasing pain, excessive bleeding, or discharge from the incision site
- Persistent cough , shortness of breath, or chest pain
- Worsening abdominal pain
- Blood in the stool
- Pain, burning, urgency or frequency of urination, or persistent bleeding in the urine
- Persistent nausea and/or vomiting
- Pain and/or swelling in your feet, calves, or legs; sudden shortness of breath or chest pain
- New or worsening symptoms
American Society for Metabolic and Bariatric Surgery http://asmbs.org
Weight Control Information Network http://www.win.niddk.nih.gov
BC Health Guide, British Columbia Ministry of Health http://www.bchealthguide.org
Canadian Laparoscopic Weight Loss Surgery http://www.weightlosssurgery.ca
Gastrointestinal surgery for severe obesity. National Institute of Diabetes and Digestive and Kidney Diseases website. Available at: http://win.niddk.nih.gov/publications/gastric.htm. Updated June 2011. Accessed December 9, 2013.
Obesity risks add to complications of gastric bypass [news release]. Duke University Medical Center website. Available at: http://www.dukemednews.org/news/article.php?id=7217. Accessed December 9, 2013.
Roux-en-Y gastric bypass. Cleveland Clinic website. Available at: http://my.clevelandclinic.org/services/procedure%5Ftreatment/gastric%5Fbypass%5Fsurgery/roux-en-y.aspx. Accessed December 9, 2013.
Roux-en-Y gastric bypass. Columbia University Medical Center website. Available at: http://obesitymd.org/gastric.html. Accessed December 9, 2013.
Roux-en-Y gastric bypass weight-loss surgery. Johns Hopkins Medicine website. Available at: http://www.hopkinsmedicine.org/healthlibrary/test%5Fprocedures/gastroenterology/roux-en-y%5Fgastric%5Fbypass%5Fweight-loss%5Fsurgery%5F135,65/. Accessed December 9, 2013.
9/2/2009 DynaMed Systematic Literature Surveillance http://www.ebscohost.com/dynamed: The Longitudinal Assessment of Bariatric Surgery (LABS) Consortium. Perioperative safety in the longitudinal assessment of bariatric surgery. N Engl J Med. 2009;361:445-454.
6/24/2011 DynaMed's Systematic Literature Surveillance http://www.ebscohost.com/dynamed: Pontiroli AE, Morabito A. Long-term prevention of mortality in morbid obesity through bariatric surgery. a systematic review and meta-analysis of trials performed with gastric banding and gastric bypass. Ann Surg. 2011;253(3):484-487. Maciejewski ML, Livingston EH, Smith VA, et al. Survival among high-risk patients after bariatric surgery. JAMA. 2011;305(23):2419-2426.
- Reviewer: Marcin Chwistek, MD; Michael Woods, MD
- Review Date: 12/2013 -
- Update Date: 01/22/2014 -