Roux-en-Y Gastric Bypass Laparoscopic Surgery

Prior to Procedure

Each bariatric surgery program has specific requirements. Your program will likely include the following:

• Thorough physical exam and review of medical history
• Attempts to lose weight (about 10%) through medically approved dietary means
• Ongoing consultations with a registered dietitian
• Mental health evaluation and counseling

Leading up to your procedure:

• Talk to your doctor about your medicines, herbs, and dietary supplements. You may be asked to stop taking some medicines up to one week before the procedure, like:
  • Aspirin or other anti-inflammatory drugs
  • Blood thinners, such as warfarin (Coumadin)
  • Clopidogrel (Plavix)
• Do not start taking any new medicines, herbs, or supplements without talking to your doctor.
• Arrange for a ride to and from the hospital.
• Arrange for help at home as you recover.
• You might take antibiotics before coming to the hospital.
• You might take laxatives and/or an enema to clear your intestines.
• The night before your surgery, eat a light meal. Do not eat or drink anything after midnight unless told otherwise by your doctor.
• Shower or bathe the morning of your surgery.

Anesthesia

General anesthesia will be used. You will be asleep.

Description of Procedure

To prepare you for surgery, a nurse will place an IV line in your arm. You may receive fluids and medicines through this line during the procedure. The doctor will place a breathing tube through your mouth and into your throat. This will help you breathe during surgery. You will also have a catheter placed in your bladder to drain urine.

Your doctor will make several small cuts in the abdomen. Gas will be pumped in to inflate your abdomen. This will make it easier for the doctor to see. A laparoscopeand surgical tools will be inserted through the incisions. A laparoscope is a thin, lighted tool with a tiny camera. It sends images of your abdominal cavity to a monitor in the operating room. Your doctor will operate while viewing the area on this monitor.

Your doctor will use surgical staples to create a small pouch at the top of your stomach. This pouch, which can hold about one cup of food, will be your new, smaller stomach. A normal stomach can hold 4-6 cups of food.

Next, the doctor will cut the small intestine and attach it to the new pouch. With the intestinal bypass, food will now move from the new stomach pouch to the middle section of the small intestine. It will skip the lower stomach and the upper section of the small intestine.

Finally, the upper section of the small intestine will be attached to the middle section of the small intestine. This will allow fluid that the lower stomach makes to move down the upper section of the small intestine and into the middle section.

Once the bypass is completed, the incisions will be closed with staples or stitches.

Be aware that in some cases, the doctor may need to switch to an open surgery. During an open surgery, she will make a larger cut in the abdomen to do the surgery.