Gastric Bypass

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Laparoscopic gastric bypass surgery (Roux-en-Y) is generally considered to be the best surgical procedure for the treatment of morbid obesity. Weight loss is achieved by reducing the functional portion of the stomach to a pouch about the size of an egg and by bypassing about 100 cm. to 150 cm. of small intestine.

After the gastric bypass procedure, the egg-sized stomach pouch causes the patient to have a sensation of fullness after eating only a small portion of food. Additionally, only a very small opening from the stomach pouch to the intestine is intentionally created during surgery to delay stomach emptying, making the sensation of fullness last longer.

The intestinal bypass portion of the procedure separates the digestive juices from the food for about 100 cm. to 150 cm. This prevents the digestion and absorption of food during the time it is separated from the digestive juices. Once the food does meet with the digestive juices, the digestive process starts; however, the creation of these permanent anatomic changes results in less absorption of nutrients and contributes to weight loss.

At Advanced Laparoscopic Associates, we specialize in performing robotic gastric bypass. It is similar to minimally invasive gastric bypass surgery, but we use an advanced surgical robot. Studies suggest that, compared to laparoscopic gastric bypass, robotic gastric bypass has similar rates of complications, length of hospital stays and recovery time, making it a safe, effective way to perform gastric bypass surgeries.

The surgeon sits at a console and manipulates four robotic arms. Three of the arms hold surgical tools and are capable of incredibly precise movements. The fourth contains a camera used to visualize the abdominal cavity, providing a high-definition 3D view unavailable with any other surgical camera.

Patients will be on a clear liquid diet for the first week immediately following gastric bypass surgery and then advance to a pureed diet for one week. These foods will be very soft so as to pass through the small, newly formed pouch. The third week consists of soft solid foods.

Approximately one month after the gastric bypass surgery, patients can expect to eat more regular table foods. Patients at this point will still be learning how to eat right, including chewing food carefully, learning to drink liquids between rather than with meals, and learning that eating the wrong foods, such as sweets or fatty foods, can cause the “dumping syndrome.”

At six months after the gastric bypass surgery, most patients will be on their long-term maintenance diet, which is more or less what and how they will eat for the rest of their lives. The maintenance diet for the most part consists of regular table foods, but in small portions. Most patients describe their meals as child-sized, and they often do not finish what they are served. Patients generally become comfortable eating these small meals and almost always say the loss of the ability to enjoy large meals or certain foods is more than compensated for by being able to successfully control their weight.

Patients may expect to lose approximately 75 percent of their excess body weight during the first two years following surgery.* Sometimes a weight regain of about 10 percent is seen between years two and five, perhaps because the small pouch increases in size and perhaps because patients learn how to take in extra calories without realizing it.

*Disclaimer: Results may vary.