In laparoscopic procedures, surgical instruments are inserted through small incisions with the help of trocars. Patients have much smaller scars compared to traditional surgeries, allowing for faster recovery and reducing the risk of infections and hernias. Laparoscopic surgery also helps protect the patient’s immune function.
Why is Roux-en-Y Gastric Bypass Performed?
While it can be done solely for weight loss, gastric bypass is also performed to treat or prevent potentially life-threatening metabolic diseases related to obesity. These include:
- Type 2 Diabetes
- Hypertension
- Gastroesophageal Reflux Disease
- Fertility problems
- Heart disease
- High cholesterol
- Sleep apnea
- Stroke
Like other obesity surgeries, gastric bypass is recommended if you have made effective efforts (such as dietary changes and exercise) to lose weight. If you have not made any efforts, other methods may be considered first.
Success Rates in Gastric Bypass Surgery
Weight loss after bypass surgery can reach 70-80% of excess weight within the first two years. In the long term, most patients maintain a loss of over 50% of excess weight. Studies show that over 50% of excess weight remains lost even 10 years after surgery. Additionally, obesity-related comorbidities improve significantly, with an improvement rate of over 80% in diabetes and over 90% in sleep apnea.
Who is Eligible for Roux-en-Y Gastric Bypass?
Generally, like other types of surgery, gastric bypass is considered if:
- Your Body Mass Index (BMI) is 40 or above (Severe Obesity)
- Your BMI is between 35 and 39.99 (Obesity), with obesity-related health issues such as Type 2 diabetes, hypertension, or severe sleep apnea
- In some cases, surgery may be performed even if your BMI is between 30 and 35, if serious weight-related health issues are present.
It is important for patients undergoing gastric bypass to commit to lifelong dietary changes. This includes maintaining adequate protein intake, taking supplements containing multivitamins, B12, iron, and calcium, and avoiding sweets and fatty foods. Although long-term vitamin supplementation is not required for every patient, it is crucial to understand these expectations before surgery.
Risks of Gastric Bypass Surgery
Besides restricting food intake, gastric bypass surgery induces weight loss by reducing the absorption of nutrients in the intestines; instead of following the usual path, food bypasses part of the stomach and the upper section of the small intestine. This can lead to long-term deficiencies in B12, folate, iron, and other vitamins and minerals if dietary supplement recommendations are not followed. Additionally, consuming sugar can cause “dumping syndrome,” which results in abdominal cramps and diarrhea. Highly fatty foods may also be poorly tolerated. Weight gain can occur in later years, particularly if post-surgery recommendations are not followed.
The reported risk for gastric bypass surgery is comparable to the risk of any surgery for an obese patient, with a mortality rate of 0.5% or less. Risks and complications, such as bleeding or intestinal leakage, occur in less than 2% of cases and decrease with the surgeon’s experience. Your surgeon should discuss the risks in detail with you before the surgery.
In conclusion, gastric bypass is not suitable for every patient. A thorough assessment and meeting certain criteria are necessary before proceeding. In some cases, another obesity or metabolic surgery option may be recommended.
The success of these surgeries is also closely related to the patient’s adherence to long-term follow-ups and the advice of the obesity surgery team members, including the surgeon, dietitian, psychologist, and, if necessary, an internal medicine/endocrinology specialist. Lifestyle modification is essential for success.