Roux-en-Y Gastric Bypass

Who is it for?

A gastric bypass may be right for you if you are an adult and one of the following applies:

• Your body mass index (BMI) is 35 or more, with or without health problems linked to your weight.
• Your BMI is between 30 and 35, and you have a health problem linked to your weight, such as type 2 diabetes, high blood pressure, sleep apnea (pauses in breathing during sleep), wear and tear of the joints (osteoarthritis), high cholesterol, or fatty liver.
• Your BMI is between 30 and 35, and other treatments have not kept the weight off.

It is often the best choice if you have:

• Strong acid reflux (heartburn) or Barrett’s esophagus.
• Type 2 diabetes, especially if you have had it for many years.
• Reflux or weight regain after an earlier sleeve gastrectomy.

How is it performed?

• You are fully asleep under general anesthesia. The operation is done by keyhole surgery through 5 to 6 small cuts and takes about one hour.
• The top of the stomach is made into a small pouch that holds about 30 mL, roughly the size of an egg.
• The small intestine is divided, and one end is joined to the new pouch. This is where your food will now go.
• The other end, which carries digestive juices from the liver, pancreas, and the bypassed stomach, is joined further down. The two joins together form the shape of a “Y”, which gives the operation its name.
• The rest of the stomach is not removed. It stays inside and keeps making digestive juices.
• Small gaps made inside the abdomen are closed with stitches, to lower the risk of a bowel twist later on (internal hernia). The joins are tested for leaks before the operation ends.

Before surgery

• A full check-up: blood tests, an abdominal ultrasound, an upper endoscopy (a camera test of the stomach), and a visit with the anesthesia doctor.
• A session with our dietitian. If your BMI is very high (over 60), you will also follow a low-calorie diet for 1 to 2 weeks before surgery, to shrink the liver and make the operation safer.
• Stop smoking at least 4 to 6 weeks before surgery, and do not start again. After a bypass, smoking can cause a painful stomal ulcer where the pouch meets the intestine.
• Tell us about all your medicines, especially for diabetes, blood pressure, and blood thinning.
• Our Fast Track program starts now and continues during and after your operation, to help you recover sooner and more comfortably.

Recovery and follow-up

• You will walk within a few hours and start sipping water on the first day. Most patients go home after one night.
• Your diet moves in steps over about six weeks: clear fluids, full fluids, puréed food, soft food, and then healthy normal meals in small portions.
• Sweets and sugary drinks can cause “dumping”: sweating, a fast heartbeat, cramps, or diarrhea soon after eating. Avoiding sweets prevents it.
• You will take vitamins every day for life: a multivitamin, vitamin B12, iron, calcium, and vitamin D. Blood tests at 3, 6, and 12 months, then once a year, keep your levels healthy. For the first 6 months, you will also take a medicine that protects you from gallstones.
• Avoid anti-inflammatory painkillers such as ibuprofen, diclofenac, and aspirin unless your doctor prescribes them. They can cause a stomal ulcer. Paracetamol is usually safe.
• Follow-up visits are at 1 week, 1 month, 3, 6, and 12 months, then twice a year, in the clinic or by video consultation.

What results can I expect?

Most patients lose about 70–90% of their extra weight over the first 12 to 18 months. Blood sugar often improves within days or weeks, even before much weight is lost, and many patients can reduce or stop their diabetes medicines. Heartburn usually improves too. Lasting results depend on the habits you build after surgery.

Conditions That May Improve

1. Morbid Obesity
2. Type 2 Diabetes
3. Acid Reflux (Heartburn)

What are the risks?

Every operation carries some risk, and we will explain yours at your consultation. The main risks are:

• A leak. This is very rare today, thanks to advanced staplers and the surgeon’s experience. If it happens, it shows within the first 7 to 10 days after surgery.
• Bleeding, in about 1 in 100 patients. It usually settles with close monitoring and treatment, without another operation.
• A stomal ulcer: a small sore where the stomach pouch meets the intestine. It is more likely if you smoke or take anti-inflammatory painkillers.
• A bowel twist or blockage (internal hernia), months or even years later. Sudden, severe tummy pain needs urgent medical care.
• Dumping after sugary meals, and low blood sugar a few hours after eating in a small number of patients.
• Bloating, gas, and diarrhea, especially after fatty meals. Eating less fat is the main way to prevent them.
• Shortages of iron, vitamin B12, calcium, and vitamin D if supplements are stopped.
• Gallstones. Fast weight loss and drinking too little water can cause them, and without prevention, about 25–30% of patients develop them. A protective medicine we prescribe for the first 6 months lowers this to about 5%, close to the usual rate in the general population.
• Blood clots in the legs or lungs. Walking early and blood-thinning injections lower this risk.
• Some weight regain over the years. Regular follow-up with our nutrition team is the best way to prevent it.

Why Choose Our Roux-en-Y Gastric Bypass Program?

• Experienced bariatric surgeons
• Advanced laparoscopic surgical techniques
• Personalized treatment plans
• Comprehensive nutritional support
• Multidisciplinary obesity care
• Modern surgical facilities