PROCEDURE DETAILS OF GASTRIC BYPASS SURGERY

What do I need to do before the Roux-en-Y gastric bypass surgery?
Your surgeon will give you specific instructions on how to prepare for the procedure. You will be required not to eat or drink for many hours before your surgery. Your stomach must be completely empty to reduce the chances of vomiting during the procedure.

What happens on the day of the surgery?
Before your operation begins, an anesthesiologist will start an IV. You will then be taken to the operating room. After the appropriate form of anesthesia is administered, surgery will be performed.

What type of anesthesia will be used?
Gastric bypass surgery is performed under general anesthesia, which means you will be asleep during your surgery.

What happens during the surgery, and how is it performed?
There are two basic steps to the surgery:
Step 1 – The first step in the surgical procedure makes your stomach smaller. The surgeon divides the stomach into a small upper section and a larger bottom section using staples that are similar to stitches. The top section of the stomach (called the pouch) will hold your food.
Step 2 – After the stomach has been divided, the surgeon connects a section of the small intestine to the pouch. When you eat, the food will now travel from the pouch through this new connection (‘Roux limb’), bypassing the lower portion of the stomach. The surgeon will then reconnect the base of the Roux limb with the remaining portion of the small intestines from the bottom of the stomach, forming a Y-shape.

An increasing number of these operations are now performed by limited access or minimally invasive techniques called ‘laparoscopy’.

Laparoscopic surgery is performed using several small incisions, or ports, one of which conveys a surgical telescope connected to a video camera, and others permit access of specialized operating instruments. The surgeon actually views his operation on a video screen.

The benefits of Laparoscopic Gastric Bypass, Roux-en-Y, include shortened hospital stay, reduced discomfort, shorter recovery time, less scarring, and minimal risk of incisional hernia.

What happens after the surgery?
Once the surgery is completed, you will be taken to a post-operative or recovery unit where a nurse will monitor your progress. You will be asked to walk the night of surgery. You will undergo a swallow study on the first postoperative day to make sure there are no problems. If there are no problems, you may be discharged on postoperative day two.

How long will I be in the hospital?
This surgery usually involves a 4 to 6 day hospital stay (2 to 3 days for a laparoscopic approach).

What are the risks associated with this procedure?
Some of the risks associated with the gastric bypass procedure are:
•    The connection between the stomach and the intestines may narrow (stomal stenosis) leading to nausea and vomiting after eating
•    The staples may pull loose
•    Hernia may develop
•    The bypassed stomach may enlarge, resulting in hiccups and bloating
•    Bleeding and infections
•    Follow-up surgeries to correct complications, or to remove excess skin
•    Gallstones due to significant weight loss in a short amount of time
•    Gastritis (inflammation of the lining of the stomach)
•    Dumping syndrome which occurs when food moves too quickly through the stomach and intestines causing nausea, weakness, sweating, faintness, and possibly diarrhea soon after eating
•    An iron and vitamin B12 deficiency which may lead to anemia
•    Calcium deficiency (if it occurs) can contribute to the development of early osteoporosis or other bone disorders
 
You are advised to discuss the possible risks and ways to avoid them with your surgeon prior to the surgery. Also, you may lessen the symptoms arising from nutritional deficiency by following your dietitian’s guidelines very carefully, especially during the first two months after surgery.

What should I watch out for?
You should call your doctor in case any of the following symptoms appear:
•    Fever
•    Worsening pain
•    Redness or swelling around the incision
•    The incision is warm to the touch
•    Drainage from the incision

Will there be scars?
The incisions should heal well, leaving small discrete scars.

When can I expect to return to work and/or resume normal activities?
Light activity at home is encouraged after surgery. Most people can return to their normal activities within 3 to 5 weeks.