Gastric Bypass

RNY gastric bypass

Gastric Bypass

For decades, Roux-en-Y gastric bypass surgery was the gold standard procedure for weight loss surgery. It is one of the most frequently performed weight loss procedures in the United States. In this procedure, stapling creates a small (15 to 20cc) stomach pouch. The remainder of the stomach is not removed, but is completely stapled shut and divided from the stomach pouch. The outlet from this newly formed pouch empties directly into the lower portion of the small intestine, thus bypassing calorie absorption. This is done by dividing the small intestine just beyond the duodenum for the purpose of bringing it up and constructing a connection with the newly formed stomach pouch. The other end is connected into the side of the Roux limb of the intestine creating the “Y” shape that gives the technique its name. The length of either segment of the intestine can be increased to produce lower or higher levels of malabsorption. By adding malabsorption, food is delayed in mixing with bile and pancreatic juices that aid in the absorption of nutrients. The result is an early sense of fullness, combined with a sense of satisfaction that reduces the desire to eat. Many studies show that diabetes goes away in up to 80% of patients after surgery!

Advantages:

  • The average excess weight loss after the Roux-en-Y procedure can be higher in a compliant patient than with purely restrictive procedures.
  • One year after surgery, weight loss can average 77% of excess body weight.
  • Studies show that after 10 to 14 years, 50-60% of excess body weight loss has been maintained by some patients.
  • A 2000 study of 500 patients showed that 96% of certain associated health conditions studied (back pain, sleep apnea, high blood pressure, diabetes and depression) were improved or resolved.

Risks:

  • Because some of the small intestine is bypassed, poor absorption of iron and calcium can result in the lowering of total body iron and a predisposition to iron deficiency anemia. This is a particular concern for patients who experience chronic blood loss during excessive menstrual flow or bleeding hemorrhoids. Women, already at risk for osteoporosis that can occur after menopause, should be aware of the potential for heightened bone calcium loss.
  • Bypassing the duodenum has caused metabolic bone disease in some patients, resulting in bone pain, loss of height, humped back and fractures of the ribs and hip bones. All of the deficiencies mentioned above, however, can be managed through proper diet and vitamin supplements.
  • A chronic anemia due to Vitamin B12 deficiency may occur. The problem can usually be managed with Vitamin B12 pills or injections.
  • A condition known as “dumping syndrome ” can occur as the result of rapid emptying of stomach contents into the small intestine. This is sometimes triggered when too much sugar or large amounts of food are consumed. While generally not considered to be a serious risk to your health, the results can be extremely unpleasant and can include nausea, weakness, sweating, faintness and, on occasion, diarrhea after eating. Some patients are unable to eat any form of sweets after surgery.
  • In some cases, the effectiveness of the procedure may be reduced if the stomach pouch is stretched and/or if it is initially left larger than 15-30cc.
  • The bypassed portion of the stomach, duodenum and segments of the small intestine cannot be easily visualized using X-ray or endoscopy if problems such as ulcers, bleeding or malignancy should occur.

If you are a self-pay patient and want info on pricing and financing for gastric bypass, click here!

Dr. Trace Curry and Dr. Tracy Pitt are among the most experienced gastric bypass surgeons in Cincinnati, Dayton, and Columbus!  Click on “Meet Dr. Curry Online” to learn more about your surgical weight loss options, or fill out the appointment request form below.

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28 thoughts on “Gastric Bypass

    1. No, the only option is the Overstitch. Just type overstitch into the search box on loseweightcincy.com for more info. It’s not covered by insurance so would have to be self pay.

  1. I have a BMI of 41.5 and have had no success in losing weight on my own. I have Cigna insurance and have Sleep Apnea – recently diagnosed – and would like to try to have this procedure under this year’s insurance deductible period (ending 12/31). Is this too aggressive?

    1. Its certainly not too aggressive and would probably be a great option for you, however its unlikely to happen before the end of the year unless you’re not going through insurance.

      Dr. Curry

  2. I had a lapband surgery in 2009. It had to be removed 3 years later due to a hernia. I had gastric sleeve 3 years later in 2012. At first I lost some weight (not a lot) and now I’m at my heaviest, four year later. At the time, the doctor offered to do either the sleeve or bi-pass. I wish I’d chose bi-pass. My insurance has changed to Molina Medicaid currently and I’m interested in getting the bi-pass. Can it be performed after the sleeve and is it covered by Molina? I do have high blood pressure, was diagnosed with sleep apnea in 2008, but did not receive treatment so I’m not sure now. My current BMI is 40.2. Thanks

  3. I have tried losing weight for 14 years now. I lose and gain it back immediately. i am over 50 bmi. My insurance will only cover if i have type 2 diabetes. I have hypoglycemia but am not diabetic. I cannot afford surgery by myself. Any advice?

    1. I would call 513-259-2555 and talk to Marcy, I’ve never seen a policy that covers weight loss surgery but only in diabetics. Might be able to appeal.

      Dr. Curry

  4. I have hsd RYN in 2012,, I have reflux back so bad that all I do is caugh after eating, sleeping and just breathing sometimes..on two meds for this.will getting revision to DS fix this…have some weight gain from depression from 187 lowest weight to 210 now highest weight was 333 before RYN..I have had two hernia surgerys and have new hernia dew to caughing so much…

    1. In cases like this we would start first with an endoscopy to assess the RNY anatomy. Call 513-559-1222 option 2 and ask to schedule a gastric bypass aftercare appointment with Dr. Udelhofen as he deals a lot with these types of issues.

    1. I believe it does, call our patient service reps at 513-259-2555 and they can tell you as well as help you with scheduling a consultation.

      Dr. Curry

  5. I need self pay financing information for gastric bypass surgery. I have struggled with my weight since I was 5 years old and I need help!!!!

    1. Ok I will have one of our patient service reps reach out with more info!

      Dr. Trace Curry
      Medical Director
      JourneyLite Physicians

    1. Hello there,
      Most RNY patients take about 2 weeks off from a desk job. Minimum stay is 23 hours.

      Dr. Trace Curry
      Medical Director
      JourneyLite Physicians

  6. i had gastric bypass 2006 and now at my same weight before surgery what can i do??? to get the weight back off?

    1. Perhaps an Overstitch may be an option, or medical weight loss. Just type Overstitch into the search box in the upper right corner of the site.

      Dr. Trace Curry
      Medical Director
      JourneyLite Physicians

  7. Hello Dr Curry
    My weight been up and down for years. I want to see if I can get surgery. But I am so scared because I have a heart murmur n asthma I also has sleep apnea. I weight 368 now and the lowest I got it on dieting was 321. Can you tell me about the gastro surgery and is that the only one care source will cover?

    1. It would probably be best to call our patient service reps at 513-259-2555 and they can explain the procedures and will probably know CareSource coverage, as I don’t off the top of my head.

      Dr. Trace Curry
      Medical Director
      JourneyLite Physicians

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