This is the current gold standard obesity surgical procedure. Since its inception in the 1970s, it has stood the test of time and is a standard for comparison of other procedures.
It is the most effective procedure for resolution of diabetes, sleep apnoea and control of hypertension. Currently, it is being studied as a purely metabolic procedure for curing diabetes even in non-morbidly-obese.
The Roux-en Y Gastric Bypass Surgery is performed laparoscopically which involves making five to six tiny incisions in the abdomen. A small gastric pouch of 15-20ml is created, which leads to a reduction of food intake at a time. The intestinal architecture is then changed so that a large portion (175-250cm) of the small intestine is bypassed, before the digestion and absorption of food starts. This results in mal-absorption of food, and subsequent weight loss.
The patient is discharged on the third or fourth day of surgery depending on the comfort of the patient and the amount of oral intake.
First, a follow-up visit is after seven days. The clips/stitches are removed. By this time the expected weight loss is around 4-8 Kgs. Further follow-up protocol is given and the patient is encouraged to participate in a routinely organized support group meeting.
It has been seen that with Gastric Bypass Surgery, Type 2 Diabetes is resolved in 82% of patients, High Blood Pressure – Resolved in 73% of patients & High Cholesterol – Improved in 93% of patients.
This procedure should be performed at tertiary care centers with a dedicated bariatric team of surgeons/anesthetists and strong ICU back up