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Roux-en-y Gastric Bypass
What you should know
Roux-en-Y gastric bypass is a type of weight loss surgery. During surgery, caregivers use staples to make a small stomach pouch that is separate from the rest of your stomach. Then they connect the jejunum (middle part of the small intestine) to the new stomach pouch. When you eat, food bypasses the rest of the stomach and goes directly into the jejunum. The surgery makes your stomach smaller so that you feel full sooner and cannot eat as much during meals. Your body will not absorb as many calories from food because part of your stomach and intestines are bypassed.
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- You may get an infection or blood clots. You may bleed too much and need a blood transfusion. Body organs including your lungs or spleen may be injured during surgery. After surgery, your stomach incision could open up. Your stomach staple line could break down. The new connections to your stomach and intestines could form scars, narrow areas, or leaks. Stomach juices may leak into your abdomen and you may need emergency surgery. You may develop gallstones or an incisional hernia (weak area near your surgical incision).
- If you often eat too much, and do not follow instructions, you may stretch out your stomach pouch. If you eat too much, too fast, or do not chew well enough you may have other problems such as feeling sick to your stomach and throwing up. If you eat sweet foods, or foods high in fat, you may get dumping syndrome. You may get acid reflux (heartburn), gas, or a stomach ulcer. Food that is not chewed well enough may get stuck in your stomach or intestines.
- You may not get enough protein, iron, and vitamins from your diet. This may lead to some hair loss, bone problems, or anemia (blood cannot carry enough oxygen). You may need a second surgery at a later time. As in any surgery, you may even die from complications. The risk of surgery must be compared with the risk of being severely obese. You may lose weight and then gain it back. You may not lose any weight. If you get pregnant while you are quickly losing weight, this could harm you and your unborn baby.
Two weeks before your surgery:
- Ask your caregiver if you should stop using aspirin or any other prescribed or over-the-counter medicine before surgery.
- You may need to have a medical exam. Bring a list of your medicines or your medicine bottles when you see your caregiver. Tell your caregiver if you use any herbs, food supplements, or over-the-counter medicines. Tell your caregiver if you have any allergies.
- Ask your caregiver for more information about these and other tests that you may need. Write down the date, time, and location of each test . You may need to have an EKG, blood and urine tests, or a chest x-ray.
- Find a bariatric (weight loss) support group. Try to find a group that is led by a bariatric dietician or other caregiver experienced with weight loss surgery. Begin attending meetings before you have your surgery.
- Buy vitamins and supplements as directed by your caregiver. Ask your caregiver for a list of the right foods to buy for after your surgery. Have these foods available at home. Buy a blender or food processor, a strainer, and measuring cups and spoons.
- Practice eating less, and slowly begin doing exercise that you can continue regularly after surgery. Ask your caregiver to help you plan a diet and exercise program that is right for you. Ask if you should keep a food and exercise diary.
The day before your surgery:
- Your caregiver may want you to empty and clean out your bowel before surgery. Doing this may keep your bowel from getting infected after surgery. Your caregiver may ask you to take medicine called a cathartic the day before surgery. This will clean out your bowel quickly.
- Ask caregivers about directions for eating and drinking.
- If you have diabetes, ask your caregiver for special instructions about what you may eat and drink before your surgery. If you use medicine to treat diabetes, your caregiver may have special instructions about using it before surgery. You may need to check your blood sugar more often before and after having surgery.
The day of your surgery:
- Write down the correct date, time, and location of your surgery.
- Ask your caregiver before taking any medicine on the day of your gastric bypass. These medicines include insulin, diabetic pills, blood pressure pills, or heart pills. Bring a list of your medicines or the pill bottles with you to the hospital.
- Do not wear contact lenses on the day of surgery. You may wear your glasses.
- An anesthesiologist may talk to you before your gastric bypass. This caregiver may give you medicine to make you sleepy during surgery.
- You or a close family member may be asked to sign a consent form. It gives your caregiver permission to do gastric bypass surgery. It also explains the possible problems that can happen with roux-en-Y surgery and your choices. Be sure all your questions have been answered before you sign this form.
- Ask a family member or friend to drive you home when you leave the hospital. Do not drive yourself home.
What will happen:
- You may be weighed and asked to change into a hospital gown. You may be given medicine in your IV to help you relax or make you drowsy. You will be taken on a cart to the operating room. You will get medicine called general anesthesia to prevent pain and keep you asleep during surgery.
- One or more incisions (cuts) are made in your stomach. Caregivers use staples to make a small stomach pouch that is shut off from the rest of your stomach. Then they cut the small intestine so that there are two ends. They connect one end of the small intestine to the stomach pouch. They connect the other end to a lower part of the small intestine. The newly placed ends of small intestine form a "Y" shape. This is why your surgery is called roux-en-Y. Caregivers will close your incisions with stitches or staples.
You will be taken to the recovery room. You will stay there until you wake up. You will then be taken back to your room. Do not get out of bed until your caregiver says it is OK. Bandages will cover your incisions. These bandages keep the areas clean and dry to help prevent infection. There may also be a small soft drain that comes out on the side of your stomach. It will be removed by your caregiver a few days or weeks after surgery.
This is a room where your family can wait until you are ready for visitors after your surgery. Your doctor or nurse will find them in the waiting room to tell them how the surgery went. If your family leaves the hospital, ask them to leave a phone number where they can be reached.
Contact a caregiver if
- You have questions or concerns about gastric bypass surgery.
- You have a fever.
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The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.