The Roux-en-Y procedure is both restrictive and malabsorptive. This means that a smaller stomach pouch is created to restrict the amount of food consumed, creating the sensation of fullness sooner than a person otherwise might. The malabsorptive aspect of the procedure means fewer calories are absorbed through the small intestine. This two-pronged approach helps many people lose weight and keep it off for the rest of their lives.
To be considered for Roux-en-Y surgery, a patient typically must be morbidly obese, often with accompanying health problems, and have exhausted all non-surgical weight-loss options. Before undergoing any type of weight-loss surgery, a patient must be evaluated by a qualified bariatric surgeon. This evaluation may include a complete medical examination and a thorough review of a prospective patient's medical history. Your pre-operative evaluation and preparation for surgery may include:
- Psychological evaluation
- Nutrition and diet counseling
- fitness education and training
- Behavioral therapy
- Support group counseling
After the necessary steps are taken in preparation for bariatric surgery, the surgeon begins the procedure.
- Creation of the pouch: Your surgeon will section off a portion of the stomach with special surgical staples. This section will create the new stomach pouch, which is about the size of one's thumb. This restrictive approach allows patients to consume less food while still experiencing the sensation of fullness.
- Division of the small intestine: After the stomach pouch is created, the small intestine is bisected.
- Attachment of small intestine to new stomach pouch: The lower part of the small intestine is then attached to the new stomach pouch. Taking this step means food passed through the stomach pouch will bypass both the lower stomach and the top of the small intestine, known as the duodenum. This malabsorptive approach is highly effective as the majority of the calories absorbed by the body are absorbed through the duodenum, and that is bypassed.
- Reattachment of upper small intestine to lower small intestine: In order to deliver essential digestive fluids produced in the top part of small intestine (which is now bypassed in the digestive process), this section of small intestine is then reattached to the lower part of the small intestine. The connection resembles a "Y," which is the basis for the unique name given this procedure.
In some cases, Roux-en-Y surgery can be performed laparoscopically. As a minimally invasive technique, laparoscopic surgery involves the use of a number of very small incisions. A surgical instrument called a laparoscope, which is equipped with a small video camera, is inserted through one of these incisions. The other necessary surgical instruments are inserted through the other small incisions. Images from the camera are then displayed on a monitor and are used by the surgeon to navigate during the surgery. The laparoscopic method of Roux-en-Y gastric bypass surgery is not right for everyone. Some may learn that the "open" Roux-en-Y technique, although more invasive, maybe be better suited for them. Your surgeon will help you determine your weight loss surgery options.
Patients should allow at least a couple of weeks to recover from roux-en-y gastric bypass surgery. Visit our bariatric surgery recovery section for more detailed information, including:
- Diet and exercise after surgery
- Weight loss surgery support groups
- Skin tightening surgery
All surgeries pose some risk, and Roux-en-Y gastric bypass is no exception. Even when performed by a competent surgeon, the possible risks associated with Roux-en-Y surgery can be serious and life threatening. According to a 2002 study, the mortality rate associated with gastric bypass surgery is less than 1.5 percent. Other possible risks after Roux-en-Y gastric bypass surgery include:
- A narrowing of the connections between the stomach and the intestines, leading to nausea and vomiting; this can occur for from 5 to 15 percent of patients
- An iron and vitamin B12 deficiency; about 50 percent of those who experience an iron deficiency develop anemia
- Ulcers in 5 to 15 percent of cases
- The development of a hernia
- The loosening of surgical staples
- An enlargement of the bypassed stomach, resulting in bloating and hiccups
In addition to these potential complications, which are specific to roux-en-y gastric bypass surgery, there are other general risks associated with all types of weight loss surgery.
Roux-en-y gastric bypass costs about $26,000. Medical bills include surgeons' fees, hospital stays, anesthesia, and lab costs. Additionally, patients must consider the cost of follow-up care, including frequent doctor's visits, vitamins and supplements, and the services of nutritionists and psychologists. Some practices will include these services in the price of surgery. Obtaining insurance coverage is often a long, complicated process; however, insurance companies are slowly realizing that within a few years they will recoup the costs of covering a weight loss surgery. Coverage for weight loss surgery varies by state and insurance carrier. Read more detailed information about bariatric surgery costs, financing, and insurance coverage.
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