Laparoscopic Roux en-y gastric bypass is a type of weight-loss/bariatric surgery. As the name suggests it can be performed through key-hole method (laparoscopy). In this technique 4 to 5 tiny cuts of half to one cm are made on the abdomen and the whole surgery is performed through these. Laparoscopic sleeve gastrectomy can also be performed in the scar-less manner through a single cut through the belly button. In a Laparoscopic Roux en-y gastric bypass, a small 30 to 50 cc stomach pouch is created using surgical staplers. Small intestine is divided at about 50 to 100 cm from the duodeno-jejunal junction and attached to the stomach pouch in a “y” shaped fashion. The food comes into the stomach pouch and flows directly into the small intestine. It bypasses the remaining stomach and the first part of small intestine.
Following are the criteria for eligibility-
Laparoscopic Roux en-y gastric bypass surgery is a restrictive and mal-absorptive procedure and can lead to an excess weight loss of about 70 to 80% on an average. This occurs over a period of 12 to 18 months. Various factors affect weight loss after bariatric surgery. It is important to recognize that obesity is a chronic progressive disease and needs life long support. Diet and lifestyle modification are mandatory after bariatric surgery to get good results and for weight maintenance.
Laparoscopic Roux en-y gastric bypass is as safe as any other surgery like gall bladder surgery or a knee replacement surgery. The overall risk of complications is less than 1%. Many complications like leak from staple lines, deep vein thrombosis and to the extent of death are listed on the web. It is important to visit a bariatric surgeon and understand the pros and cons and not just rely on hearsay and information on google. Regular follow up along with diet and behaviour modification is the key to long term success after bariatric surgery. There should be no weakness after the initial few weeks of surgery. If you continue to feel weak then you must get in touch with the bariatric team for further evaluation.
Till date, out of millions of patients who have undergone a laparoscopic Roux en-y gastric bypass only 1 or 2 cases of cancer in the remnant stomach have been reported. Yearly upper GI endoscopy is recommended after bariatric surgery.
Dr. Aparna Govil Bhasker is a Bariatric and Advanced Laparoscopic Surgeon.
Affiliations: Global Hospital, Parel; Apollo Hospitals, CBD Belapur, Tradeo and Chembur; Currae Hospital, Thane; Suchak hospital, Malad and Namaha Hospital, Kandivali