What is Gastric Bypass Surgery (roux-en-y-gastric bypass)?

Gastric bypass surgery (roux-en-y-gastric bypass) has been performed for over thirty years, the longest of all three weight loss surgeries.

Dr. LeGrand performs gastric bypass surgery in two parts. First, he creates a very small new stomach with a one-ounce capacity called the “pouch.” It is the only part of the stomach that will ever receive food after surgery. Dr. LeGrand then bypasses, or reroutes, the intestines to carry food away from the pouch. Second, Dr. LeGrand makes a connection allowing digestive juices coming from the remaining stomach, liver and pancreas to meet with the food downstream.

Gastric Bypass Surgery

(Before and After)

How does gastric bypass help people lose weight?

Gastric bypass is a combined procedure, which means it restricts portion size and limits the absorption of foods, a process called “malabsorption.” The small pouch restricts how much food you can eat and leaves you feeling full after only a few bites. Gastric bypass is also a metabolic surgery that changes how you metabolize food. Through the physical changes brought on by the procedure, neurochemical pathways and hormones are altered in a favorable way to help you lose weight rapidly, give you better control of your blood sugars and decrease inflammation.

Gastric bypass also causes a phenomenon called dumping syndrome. Dumping is usually brought on by consuming refined sugars. It is a very uncomfortable feeling characterized by weakness, nausea, sweating and physically feeling bad. It acts as a useful side effect to help deal with a major food trigger.

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What are the advantages of gastric bypass surgery?

History

Gastric Bypass has a long history of positive and proven results.

A Combined Approach

Gastric Bypass combines portion restriction with malabsorption for rapid, significant, long-term weight loss.

Proven Results

Gastric Bypass has delivered proven results in both adults and young adults.

Additional Benefits

Gastric Bypass has also been shown to relieve joint pain, relieve depression, eliminate obstructive sleep apnea, and more.

What are the side effects and disadvantages of gastric bypass surgery?

Low Risk

Low risk of side effects, only about 10% of people experience complications.

Blood Clots

Blood clots in the lung are possible. Blood thinners are administered to reduce this risk.

Side Effects

Some side effects include constipation and gall stones.

Who makes a good candidate for gastric bypass surgery?

Body Mass Index (BMI)

  • Individuals with a body mass index (BMI) of at least 40, meaning at least 100 pounds overweight.
  • Individuals with a BMI of 35 with a chronic weight-related health condition such as type 2 diabetes, high blood pressure, or sleep apnea.
  • Inability to achieve healthy weight loss sustained for a period of time through prior weight loss efforts.
  • Depending on BMI, some individuals may be too heavy for gastric bypass surgery but could be a good candidate for another weight loss procedure. Dr. LeGrand will discuss those other options.

Overall Health

If you’re considering gastric bypass surgery, you may also have weight-related health issues; however, you’ll need to be able to withstand the physical stress of surgery. Dr. LeGrand will review your medical history and current health. Additional tests may be needed to ensure you’re able to physically handle the surgery and recovery.

Commitment to Diet Maintenance

Our dietician can help you follow a plan that meets your dietary requirements and maximizes nutrition. Following a plan will help you avoid eating more than you should in the long term. If you do overeat, it’s possible to stretch your new, smaller stomach and regain weight. You’ll learn some important guidelines and will need to follow them strictly including:

  • Chew everything well before swallowing. Begin this practice even before surgery. You will become a more mindful eater through this healthy habit.
    Consume your food and drink separately. Extra fluid with food will make you feel full too fast and prevent you from getting proper nutrition.
  • Drink a liquid 30 minutes before each meal. Hydration is vital to good health. You would normally get a substantial amount of liquid from the foods you eat. Since you won’t be able to eat as much following surgery, you still need to be mindful about getting adequate water for healthy kidneys, liver, skin and every part of your body.
  • Avoid calorie-packed foods and drinks that have little nutritional value. You’ll be eating less food after surgery, so you need to ensure the foods you do eat will deliver the nutrition your body needs. You won’t have much room for anything else.

Moderators vs. Abstainers

Moderators are able to very occasionally and selectively have junk food. If you have trouble moderating, you should become an abstainer. You will be more successful abstaining completely because once you get a taste of foods low in nutritional value, you will have trouble stopping. Make a commitment to yourself and your health. Avoid buying things you shouldn’t eat or drink. Start these techniques before surgery to keep your weight loss commitment.

Commitment to Exercise

Exercise is important to achieving post-surgery success. Exercising three or more times per week is highly recommended. Find various activities you enjoy so you remain engaged. You will notice exercise and all activities will get easier as you lose weight.

Willingness to Take Nutritional Supplements

Taking multiple vitamin and mineral supplements the rest of your life will become necessary as your new, smaller stomach will hold less food. Even nutrient dense foods will be limited by your stomach’s size. Recommended supplements include a multi-vitamin, calcium and vitamin B12.

Psychological Readiness and Support

Physical changes aren’t the only effects you will experience after gastric sleeve surgery. You will notice psychological effects, too. For example, if overeating was your common response to stress, continuing to do so after surgery could stretch your stomach and regain the weight you’ve worked so hard to lose. Your relationships might change, too. Surround yourself with people who support you in making your health a priority.

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How is gastric bypass performed?

Dr. LeGrand performs the procedure laparoscopically, a minimally invasive approach, in about two to three hours. General anesthetic will be used to put you to sleep. Several small incisions will be made in your abdomen. Dr. LeGrand will insert narrow tubes in the incision that contain cameras and small surgical tools. Dr. LeGrand will see the inside of your abdomen and safely make surgical adjustments to your stomach.

Dr. LeGrand performs gastric bypass surgery in two parts. First, he creates a very small new stomach with a one-ounce capacity called the “pouch.” It is the only part of the stomach that will ever receive food after surgery. Dr. LeGrand then bypasses, or reroutes, the intestines to carry food away from the pouch. Second, Dr. LeGrand makes a connection allowing digestive juices coming from the remaining stomach, liver and pancreas to meet with the food downstream.

By performing the procedure laparoscopically, scarring, surgical risks and recovery time are minimized. Only a few stitches will be needed to close the small incisions.

What should I expect post-op following gastric sleeve weight loss surgery?

You may stay in the hospital for one or two nights. Your first goals after surgery are to walk frequently and do breathing exercises with a tool called an incentive spirometer. You will be given blood-thinning medications to prevent blood clots. Patients are typically allowed to sip liquids a few hours after surgery.

Day 1 | Post Op

Transition completely from IV fluids and medications to oral intake and liquid pain medications.

Day 2 | Discharge

Most patients are discharged, but everyone is different. You should be completely comfortable before going home, which may require an extra hospitalization day.

Post-Hospital Recovery

Transition completely from IV fluids and medications to oral intake and liquid pain medicationsYour post-op regimen begins. Your smaller stomach will extremely limit what you can eat. After one to two months, you will revisit the healthy eating and lifestyle habits you began adopting before surgery, including exercise.

Taking multiple vitamin and mineral supplements the rest of your life will become necessary as your new, smaller stomach will hold less food, even nutrient dense foods. Recommended supplements include a multi-vitamin, calcium and vitamin B12.

What type of weight loss can be expected following gastric bypass surgery?

Individual results vary, but people who have had gastric bypass surgery, and comply with our guidelines, lose about 20% to 25% of their excess weight within two months.  For example, if your excess body weight is 100 pounds, you can lose about 20 to 25 pounds in eight weeks.  You can lose about 30% to 35% of your excess weight in about three months after surgery.  Proper diet and exercise can expedite your weight loss.

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How is gastric bypass surgery different from gastric sleeve surgery?

In gastric bypass, Dr. LeGrand makes a small pouch that bypasses the lower part of your stomach.  Food is redirected to the top of the stomach straight into the small intestines.  Gastric bypass is a combined procedure, which means it restricts portion size and limits the absorption of foods, a process called “malabsorption.”  It is a metabolic surgery that changes how you metabolize food.

The gastric sleeve procedure is similar, but the shape and size of the stomach after the procedure is more like that of a banana or hockey stick making the functional stomach more like a tube than a bag.  Through gastric sleeve surgery, Dr. LeGrand removes 80% to 85% percent of the stomach and staples the remaining portion of the stomach together.  This restrictive procedure limits the amount of food the patient can consume but doesn’t necessarily change how you metabolize food.

Gastric Sleeve

Weight Loss Surgery (Before and After)

Gastric Bypass Surgery

(Before and After)

How do I prepare for my surgery date?

Leading up to surgery, you’ll complete several evaluations and education preparing you for post-op success.  You’ll practice new, healthy lifestyle skills early on because it takes time to develop new habits.  Your results and success completely depend on your ability to permanently adopt healthy habits.

You may experience weight loss even before surgery because of your lifestyle changes.  You should be encouraged by this weight loss and gain confidence in your long-term success.  The gastric bypass surgery, as well as support from your medical and personal teams, will help you remain successful.

When will my new diet begin?

Two weeks before surgery, you’ll begin a very strict diet.  Calories and carbohydrates will be restricted while your intake of lean proteins will be increased.  These dietary changes will help shrink the liver and prepare your body for a smooth transition to a new lifestyle.  An oversized liver could compromise your success and make the surgery more dangerous.

Two days before surgery, you will switch to a liquid diet that may include broth and protein shakes.  You may also be able to drink decaffeinated coffee and tea and eat Jell-O.  Avoid caffeine as it could impact your procedure.  No two patients are alike, so Dr. LeGrand’s orders may vary.

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