Gastric Bypass – Bariatric Surgery

To perform gastric bypass surgery, your surgeon will create a small gastric pouch out of the top part of your stomach and connect it to a loop made from your small intestine. The other end of the small intestine loop will then be reconnected to a lower point of the small intestine. Both junctures are called an anastomosis. As a result of this restructuring, you will have a smaller stomach, and food will totally bypass most of the stomach before entering the intestines.

The procedure is done laparoscopically under general anesthesia and typically takes an hour and a half to three hours. You will need to remain hospitalized for two to four days, and you should be able to return to normal functioning quickly, about a week later.

During the first one to two weeks after gastric bypass, your diet will consist only of liquids (e.g., smooth soup, yogurt). Slowly, you will be able to add soft foods, and usually patients are able to progress to regular food about six weeks later.

The initial weight loss may be rapid, and because of the malabsorption process, you will need to take vitamin and mineral supplements to ensure that your body gets all the necessary nutrients of a healthy diet. Generally, you will need to continue taking these supplements for the rest of your life.

There are four different types of gastric bypass procedures:

• Gastric bypass, Roux en-Y (RYGB, proximal) – this is the most commonly performed technique. A small stomach pocket is formed, and the small intestine is divided and arranged into a “Roux en-Y” loop near its upper (proximal) end. Food flows from the gastric pouch through this Y-shaped loop, which consists of only a small portion of the intestine. You will feel full faster due to having a smaller stomach, and less food is absorbed because it bypasses the upper small intestine.
• Gastric bypass, Roux en-Y (RYGB, distal) – this procedure creates a small gastric pouch and forms the “Roux en-Y” loop lower down the small intestine (closer to the distal end), so the portion of the intestine that can fully absorb nutrients is very small. Generally, the effects on nutritional absorption are greater.
• Mini-gastric bypass (MGB) – this surgery reshapes the stomach into a long narrow tube, which is connected to a loop of the small intestine, placed low on the intestine. Due to the simplicity of the procedure and the low complication rate, this method is growing in popularity.
• Endoscopic duodenal-jejunal bypass sleeve (DJBL) – also called an EndoBarrier, this relatively new procedure implants a bypass liner between the primary portion of the small intestine and the secondary portion of the small intestine. As a result, partially digested food cannot enter the secondary stage of the small intestine, and you will feel full quickly after eating.