Laparoscopic Roux-en y gastric bypass is one of the oldest bariatric/weight loss procedures being performed across the world. It was started in the seventies and is popularly considered as the gold-standard procedure for weight loss. It has very good weight loss results. It is also performed to treat type 2 diabetes in patients suffering from obesity.
As the name suggests, laparoscopic Roux-en y gastric bypass in Kolkata is performed through the keyhole approach. 5 tiny cuts are made on the tummy and a camera is inserted through one of the ports. The entire surgery is performed looking at a monitor. Once the trocars are inserted the abdomen is visualized internally. A small vertical pouch of the stomach (30-50 cc) is created using staplers and the small intestine is rerouted and joined to this stomach pouch in a Y shaped connection. The food comes into the stomach pouch and goes down directly into the small intestine. The remaining part of the stomach, the duodenum and the first 75 to 100 cm of jejunum are bypassed in this surgery. At times, a silicon band may also be applied on the stomach pouch. This helps in long term weight maintenance.
As explained above, the stomach pouch is very small and patients are able to consume very little food after the surgery. Food intake is restricted and the stomach feels full much faster. The part of stomach which is bypassed, contains a hormone called “ghrelin” which induces hunger. As most of the ghrelin does not get activated after this surgery, this leads to a significant reduction in hunger. Hence, patients eat less, feel full earlier and do not feel hungry after this surgery. Food directly passes into the small intestine from the gastric pouch and this leads to some caloric mal-absorption also. In addition to this, certain gastro-intestinal hormones are released that augment weight loss and also help in improving diabetes.
After a Roux-en y gastric bypass, the weight loss happens over 12 to 18 months. Most patients lose about 70 to 80% of their excess body weight. Weight loss is the fastest in the first 3 to 6 months after which it tends to slow down. Weight loss results as well as weight maintenance are better in patients who embrace lifestyle modification after surgery. A healthy diet and an hour of daily exercise goes a long way in maintaining a good weight after surgery.
A laparoscopic Roux-en y gastric bypass leads to significant improvement in diseases associated with obesity. There is a marked improvement in type 2 diabetes, high blood pressure, cholesterol levels, uric acid levels, PCOD, joint pains, sleep apnoea, fatty liver and other diseases. There is a significant decrease in the number of medications that the patients were on earlier. Weight loss also leads to improved confidence. In general, the quality of life is much better after any kind of weight loss procedure.
Once you decide to undergo bariatric surgery, you will need to undergo investigations. These include blood tests and radiological tests. An upper GI endoscopy will also be done. A sleep study will be done if you have symptoms of sleep apnoea. A physician fitness and anesthesia fitness will be done after your investigations are done. 7 days before the surgery, you will be started on a high-protein liquid diet. This diet not only helps to lose some weight before the surgery but also reduces the swelling on the liver, thus making surgery easier and safer.
You will be admitted to the hospital, the evening before the surgery for pre-surgery preparation.
After the surgery, you will be kept nil by mouth. You will be made to walk after 4 to 6 hours of surgery and from the next day oral liquids will be started. You may get discharged either on day 1 or the morning after that.
You will be on liquids orally for the first 15 days, followed by semi-solids for another 15 days. You can join work after 7 to 10 days of surgery.
Risks and complication rate after laparoscopic Roux-en y gastric bypass is about 1 to 2%. It is as safe as any other surgery such as gall bladder surgery or knee replacement surgery. Patients will need to take life-long nutritional supplements. There is a chance of developing nutritional deficiencies if due care is not taken. The chances of staple line leak, embolism and other complications is less than 1%. Long term risks of Roux-en y gastric bypass are internal herniation and marginal ulcers. Regular follow up with your bariatric surgeon is recommended to prevent these complications or to diagnose them at the earliest. Weight regain can happen if due care is not taken to maintain the weight.
Our center is Park-view hospital which is situated in Salt-Lake city in Kolkata. The cost of laparoscopic Roux-en y gastric bypass in Kolkata is very affordable here and depends on the type of room that you select and the number of days you stay in the hospital. Some insurance companies now cover bariatric surgery and you may be able to claim for re-imbursement. Medical loan may also be an option and the payment can be made in the form of an EMI. However, please remember that the cost of bariatric/weight loss surgery is much lower than the cost of obesity and its related diseases. In the long term you will be spending much lesser and bariatric surgery turns out to be the cheaper option.
Dr. Amit Bhatt underwent a laparoscopic banded Roux-en y gastric bypass in 2017. At the time of surgery his weight was 140 kg. He suffered from breathlessness, joint pains and it was affecting his quality of life. As a busy doctor he was finding it difficult to cope up with work. He lost 55 kg in 24 months and is maintaining a healthy weight between 84 to 86 Kgs. Since the surgery, his energy levels have improved and he is living his life to its full potential. He regularly works out in the gym and maintains a healthy diet. He is an inspiration and a living example that no goal in life is unachievable and if one sets their mind onto something then it can be done.