What is Laparoscopic Gastric Bypass Surgery

Gastric bypass, also called Roux-en-Y gastric bypass, is a type of weight loss surgery (bariatric surgery). This procedure helps you lose weight by making your stomach much smaller.

This limits the amount of nutrients you can absorb. You may need this procedure if you are dangerously overweight. It may also help reduce your risk of developing type 2 diabetes.

This procedure is done though small incisions in your abdomen (laparoscopic surgery). A thin scope with a camera (laparoscope) is inserted through one incision. Thin surgical instruments are inserted through the other incisions. In some cases, a laparoscopic procedure may be turned into a type of surgery that is done through a larger incision (open surgery).

Tell a health care provider about:

• Any allergies you have.
• All medicines you are taking, including vitamins, herbs, eye drops, creams, and over-the-counter medicines.
• Any problems you or family members have had with anesthetic medicines.
• Any blood disorders you have.
• Any surgeries you have had.
• Any medical conditions you have.
• Whether you are pregnant or may be pregnant.

What are the risks?

Generally, this is a safe procedure. However, problems may occur, including:

• Infection.
• Bleeding.
• Allergic reactions to medicines or dyes.
• Damage to other structures or organs.
• A blood clot that forms in the leg and travels to the heart or lungs.
• Leaking of digestive juices into the abdomen.
• Pneumonia.

Long-term risks and complications may occur, including:

• Lack (deficiency) of vitamins and minerals.
• Dehydration.
• Malnutrition.
• Low blood sugar (hypoglycemia).
• Bowel obstruction.
• Incisional hernia.
• Gallstones.
• Narrowing of the digestive tract (stricture or stenosis).
• Ulcers.
• Diarrhea, nausea, or vomiting after eating (dumping syndrome).
• Needing to have the surgery repeated if complications develop (revision surgery).

What happens before the procedure?

• You will have a complete exam and assessment of your nutrition status. You will also meet with a nutrition specialist (dietitian) to learn about nutrition after surgery. In some cases, you may meet with a mental health specialist (psychologist).
• Follow instructions from your health care provider about eating or drinking restrictions.
• Ask your health care provider about:
  • Changing or stopping your regular medicines. This is especially important if you are taking diabetes medicines or blood thinners.
  • Taking medicines such as aspirin and ibuprofen. These medicines can thin your blood. Do not take these medicines before your procedure if your health care provider instructs you not to.
• Ask your health care provider how your surgical site will be marked or identified.
• You may be given antibiotic medicine to help prevent infection.
• Plan to have someone take you home after the procedure.

What happens during the procedure?

• To reduce your risk of infection:
  • Your health care team will wash or sanitize their hands.
  • Your skin will be washed with soap.
• An IV tube will be inserted into one of your veins.
• You will be given a medicine to help you relax (sedative) and a medicine to make you fall asleep (general anesthetic).
• Several small incisions will be made in your abdomen.
• The laparoscope will be placed through one incision. The laparoscope will send images to a video screen in the room.
• Laparoscopic surgical instruments will be placed through the other incisions.
• The top part of your stomach will be separated from the rest of your stomach. The open ends will be closed with a stapling tool.
• The upper part of your small intestine will be divided.
  • The lower end will be brought up and attached to your new, smaller stomach.
  • The upper end will be attached lower down on your small intestine. This end will remain attached to the rest of your stomach.
  • All of the attachments will be stapled together.
• The laparoscope and surgical instruments will be removed.
• Your abdominal incisions will be closed with stitches (sutures), staples, or adhesive strips.
• Light bandages (dressings) will be placed over your incisions.

The procedure may vary among health care providers and hospitals.

What happens after the procedure?

• Your blood pressure, heart rate, breathing rate, and blood oxygen level will be monitored often until the medicines you were given have worn off.
• You will be given medicine to help relieve pain.
• You will continue to get fluids and nutrition through an IV tube. You will begin a liquid diet after the first day. Your IV will be removed when you are taking your liquid diet well.
• You will be encouraged to get up and walk around to prevent blood clots.
• You may have to wear compression stockings. These stockings help to prevent blood clots and reduce swelling in your legs.
• You will be encouraged to breathe deeply and cough. This helps to prevent pneumonia.
• You may meet with a dietitian to discuss your diet at home.
• Do not drive for 24 hours if you received a sedative.

Laparoscopic Gastric Bypass Surgery, Care After

Refer to this sheet in the next few weeks. These instructions provide you with information about caring for yourself after your procedure. Your health care provider may also give you more specific instructions. Your treatment has been planned according to current medical practices, but problems sometimes occur. Call your health care provider if you have any problems or questions after your procedure.

What can I expect after the procedure?

After the procedure, it is common to have:

• Pain.
• Fatigue.
• Nausea.
• Gas or heartburn.

Follow these instructions at home:

Eating and drinking

• Drink enough fluid to keep your urine clear or pale yellow.
• Follow instructions from your health care provider or nutrition specialist (dietitian) about:
  • What to eat and how much to eat. This is very important.
  • How long you need to stay on a liquid diet.
  • Taking any vitamins or protein supplements.
• You will begin by drinking liquids in small amounts. Liquids may include tea, juice, broth, or gelatin.
• Do not drink caffeine for 1 month, or as long as told by your health care provider.
• Do not drink alcohol.

Activity

• Take walks throughout the day. Do not sit for longer than one hour while you are awake for 4–6 weeks or as long as told by your health care provider. This is important.
• Do coughing and deep breathing exercises as told by your health care provider.
• Return to your normal activities as told by your health care provider. Ask your health care provider what activities are safe for you.
  • Avoid activities that require a lot of energy for as long as told by your health care provider.
  • Do not lift, push, or pull anything that is heavier than 10 lb (4.5 kg).

Driving

• Do not drive or operate heavy machinery while taking prescription pain medicine.
• Do not drive for 24 hours if you received a medicine to help you relax (sedative).

Incision care

• Follow instructions from your health care provider about how to take care of your incisions. Make sure you:
  • Wash your hands with soap and water before you change your bandages (dressings). If soap and water are not available, use hand sanitizer.
  • Change your dressings as told by your health care provider.
  • Leave stitches (sutures), skin glue, or adhesive strips in place. These skin closures may need to be in place for 2 weeks or longer. If adhesive strip edges start to loosen and curl up, you may trim the loose edges. Do not remove adhesive strips completely unless your health care provider tells you to do that.
• Do not take baths, swim, or use a hot tub until your health care provider says that it is okay. You may shower when your health care provider says that it is okay.
• Pat your incisions dry. Do not rub them.
• Check your incision areas every day for signs of infection. Check for:
  • More redness, swelling, or pain.
  • More fluid or blood.
  • Warmth.
  • Pus or a bad smell.

General instructions

• Take over-the-counter and prescription medicines only as told by your health care provider.
• Do not use any tobacco products, such as cigarettes, chewing tobacco, or e-cigarettes. If you need help quitting, ask your health care provider.
• Keep all follow-up visits as told by your health care provider. This is important.

Contact a health care provider if:

• You have a fever or chills.
• You have a cough that does not go away.
• You have pain that does not get better with medicine.
• You feel nauseous or you vomit.
• You have pain or discomfort with swallowing.
• You have more redness, swelling, or pain around your incisions.
• You have more fluid or blood coming from your incisions.
• Your incisions feel warm to the touch.
• You have pus or a bad smell coming from your incisions.
• You have diarrhea, nausea, or vomiting after eating (dumping syndrome).

Get help right away if:

• You develop shortness of breath.
• You develop chest pain.
• You have very bad pain in your leg.
• You have severe abdominal pain, nausea, and vomiting.