Gastric Bypass

According to the American Society for Bariatric Surgery and the National Institutes of Health, Roux-en-Y  gastric bypass is the most frequently performed weight loss surgery in the United States. In this procedure, stapling creates a small (15 to 20cc) stomach pouch.

The remainder of the stomach is not removed, but is completely stapled shut and divided from the stomach pouch. The outlet from this newly formed pouch empties directly into the lower portion of the jejunum, thus bypassing calorie absorption. This is done by dividing the small intestine just beyond the duodenum for the purpose of bringing it up and constructing a connection with the newly formed stomach pouch.

The other end is connected into the side of the Roux limb of the intestine creating the "Y" shape that gives the technique its name. The length of either segment of the intestine can be increased to produce lower or higher levels of malabsorption. Through the surgical creation of a small pouch out of a portion of the stomach, the patient is given a ”tool” to help him or her gain control over the feeling of hunger. Long-term weight control is dependent upon using this pouch/tool correctly, along with adopting a healthy lifestyle that includes good nutrition and exercise.

Initial weight loss (1 to 6 months) occurs due to the fact that it does not take much food or liquid to fill the new small pouch. Therefore, satiety or “feeling full” is reached very quickly. Moderate to rapid weight loss occurs during this time but it is very important that the patient follow the recommended diet in order to stay healthy by taking in sufficient amounts of protein, vitamins, and minerals. It is also important during these months that the patient starts getting into the habit of living a healthy lifestyle.

Over time, some patients note a moderate increase in their appetite (6-12 months). The patient continues to maintain control over hunger by filling the pouch/tool with just enough nutritious food at each mealtime. By doing so, the pouch/tool actually stretches very slightly which signals stretch nerves to tell the brain cut off feelings of hunger and replace with feelings of fullness.