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Roux-en-y Gastric Bypass
WHAT YOU NEED TO KNOW:
Roux-en-Y gastric bypass is a type of weight loss surgery. During surgery, healthcare providers 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.
WHILE YOU ARE HERE:
- Informed consent is a legal document that explains the tests, treatments, or procedures that you may need. Informed consent means you understand what will be done and can make decisions about what you want. You give your permission when you sign the consent form. You can have someone sign this form for you if you are not able to sign it. You have the right to understand your medical care in words you know. Before you sign the consent form, understand the risks and benefits of what will be done. Make sure all your questions are answered.
- Heart monitor: This is also called an ECG or EKG. Sticky pads placed on your skin record your heart's electrical activity.
- An IV is a small tube placed in your vein that is used to give you medicine or liquids.
- You may need to wear pressure stockings. The stockings are tight and put pressure on your legs. This improves blood flow and helps prevent clots.
- You may need to wear inflatable boots after surgery. The boots have an air pump that tightens and loosens different areas of the boots. This device improves blood flow and helps prevent clots.
- A pulse oximeter is a device that measures the amount of oxygen in your blood. A cord with a clip or sticky strip is placed on your finger, ear, or toe. The other end of the cord is hooked to a machine.
- Vital signs: Caregivers will check your blood pressure, heart rate, breathing rate, and temperature. They will also ask about your pain. These vital signs give caregivers information about your current health.
- Pre-op care: You may be weighed and asked to change into a hospital gown. You may be given medicine in your IV to make you feel sleepy and more relaxed. You will be taken on a cart to the room where your surgery will be done. Your healthcare provider will help you get comfortable on the bed. Belts may be put over your legs for safety. If you get cold, ask for more blankets.
- General anesthesia will keep you asleep and free from pain during surgery. Anesthesia may be given through your IV. You may instead breathe it in through a mask or a tube placed down your throat. The tube may cause you to have a sore throat when you wake up.
One or more incisions (cuts) are made in your stomach. Healthcare providers 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 will connect one end of the small intestine to the stomach pouch. They will 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. Healthcare providers 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 healthcare provider says it is OK. Bandages will cover your incisions. These bandages keep the areas clean and dry to help prevent infection.
- Activity: You may need to walk around the same day of surgery, or the day after. Movement will help prevent blood clots. You may also be given exercises to do in bed. Do not get out of bed on your own until your caregiver says you can. Talk to caregivers before you get up the first time. They may need to help you stand up safely. When you are able to get up on your own, sit or lie down right away if you feel weak or dizzy. Then press the call light button to let caregivers know you need help.
- Take deep breaths and cough 10 times each hour. This will decrease your risk for a lung infection. Take a deep breath and hold it for as long as you can. Let the air out and then cough strongly. Deep breaths help open your airway. You may be given an incentive spirometer to help you take deep breaths. Put the plastic piece in your mouth and take a slow, deep breath, then let the air out and cough. Repeat these steps 10 times every hour.
- You will start eating by sipping water or chewing on ice chips. Then you will be started on a sugar-free, clear liquid diet. Examples of sugar-free, clear liquids are broth, jello, and clear juice. You may only be able to eat a few teaspoons of liquid at the beginning. Stop eating when you feel full, even if you have food (liquid) left over.
- Next, you will be given a sugar-free, full liquid diet. This may include liquids such as high protein drinks and dairy product drinks. This may also include non-creamed soups pureed in a blender. You may only be able to have a small amount of liquid before you feel full. You may need to follow a full liquid diet for a while after going home from the hospital. You will slowly be able to add other foods over time. In time, you should be able to eat about one-half to two-thirds of a cup of regular food during each meal.
- A Foley catheter is a tube put into your bladder to drain urine into a bag. Keep the bag below your waist. This will prevent urine from flowing back into your bladder and causing an infection or other problems. Also, keep the tube free of kinks so the urine will drain properly. Do not pull on the catheter. This can cause pain and bleeding, and may cause the catheter to come out.
- Antibiotics: This medicine is given to help treat or prevent an infection caused by bacteria.
- Antinausea medicine: This medicine may be given to calm your stomach and to help prevent vomiting.
- Blood thinners help prevent blood clots. Blood thinners may be given before, during, and after a surgery or procedure. Blood thinners make it more likely for you to bleed or bruise.
- Pain medicine: Caregivers may give you medicine to take away or decrease your pain.
- Do not wait until the pain is severe to ask for your medicine. Tell caregivers if your pain does not decrease. The medicine may not work as well at controlling your pain if you wait too long to take it.
- Pain medicine can make you dizzy or sleepy. Prevent falls by calling a caregiver when you want to get out of bed or if you need help.
- You may need extra oxygen if your blood oxygen level is lower than it should be. You may get oxygen through a mask placed over your nose and mouth or through small tubes placed in your nostrils. Ask your healthcare provider before you take off the mask or oxygen tubing.
- 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.
CARE AGREEMENT:You have the right to help plan your care. Learn about your health condition and how it may be treated. Discuss treatment options with your caregivers to decide what care you want to receive. You always have the right to refuse treatment.
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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.