Roux en Y gastric bypass is a combination procedure and also the most commonly performed weight loss surgery in the United States. Synergy Bariatrics offers this procedure through the open approach.

Gastric bypass involves the creation of a small pouch from a permanent surgical division of the stomach to restrict the volume of food that can be eaten. This pouch is then connected directly to the jejunum (the latter portion of the small intestine) causing malabsorption of some nutrients, vitamins, and minerals. The remaining portion of the stomach stays intact while the bypassed portion of the small intestine continues to drain bile and pancreatic juices at another connection further down the intestine.

Copied with permission © 2006 Ethicon Endo Surgery, Inc.

Most patients achieve significant weight loss after gastric bypass surgery. After one year, 95% of patients lose at least 40% excess body weight, and overall, an average loss of 60-65% can be expected. The amount of weight lost varies with initial BMI, compliance with diet recommendations and participation in regular exercise. Most patients will sustain this weight loss over the long-term; however, gastric bypass surgery is only a tool. The key to success is a healthy lifestyle change.

Gastric bypass is considered to be major abdominal surgery, and as such, there are risks and complications. Although the mortality rate is very small ( < 0.3% at Synergy Bariatrics), it is important to take this and other risks into consideration. Click here to read more detailed information.

Most patients are in the hospital for three days, able to shower on the third day, and able to drive by one week. Many return to work, at least part time, within 2 weeks, although those who do heavy work may need 4-6 weeks off.

Surgical Weight Loss Outcomes

* % Excess Weight Loss is the standard measure of weight loss following surgery.

Christou NV, Sampalis JS, Liberman M, et al. Surgery Decreases Long-Term Mortality, Morbidity, and Health Care Use in Morbidly Obese Patients. Annals of Surgery 2004;240(3):416-424.

Metabolic and hormonal changes that occur as a result of gastric bypass are not yet completely understood. However, the suppression of an appetite-stimulating stomach hormone called Ghrelin is an important contributor to weight loss. Patients are not as hungry as they were before surgery and experience a feeling of fullness from drastically smaller meals. Additionally, fried or sugary foods are not well tolerated, and unpleasant symptoms from “dumping syndrome” reinforce the selection of healthy foods.

Because of the implications gastric bypass surgery has upon the absorption of nutrients and the suppression of hunger, it is critical that patients adhere to specific nutrition guidelines. Click here for more information on this site about these guidelines and the goals for eating and drinking after surgery.

Gastric bypass can be performed using either an open or a laparoscopic approach.

The laparoscopic approach to gastric bypass utilizes several small incisions in the abdomen. These openings allow for the insertion of small surgical instruments and a tiny video camera-like device called a laparoscope. Advantages to this method include:
• Less pain during recovery
• Fewer instances of infection or hernia in the wound
• Patients may return to work sooner

Copied with permission © 2006 Ethicon Endo Surgery, Inc.

However, laparoscopic gastric bypass is not appropriate for all patients. Some conditions which may make it difficult to perform include:
• History of prior abdominal surgery
• Presence of liver disease
• Small rib cage opening

The open technique refers to the use of one central incision (usually 5 – 7 inches long). The majority of the procedures performed by the Synergy Bariatrics surgical team have utilized the open approach with great success. Despite national trends for longer hospitalization with open gastric bypass versus laparoscopic gastric bypass, our patients have been well enough to go home after an average of two days in the hospital. Complication rates are the same as with the laparoscopic technique, and most incisions heal very well.