According to the Mayo Clinic, gastric bypass (Roux-en-Y or RNY) is the most frequently performed weight loss surgery in the United States, and generally has the lowest rate of complications. Gastric bypass can be performed through an incision in the abdomen, or by introducing a laparoscope — a tubular surgical instrument with a camera attached — through small incisions in the abdomen. Many surgeons prefer the laparoscopic technique there are generally fewer complications and the patient recovers faster.
How It Works
If you have a gastric bypass procedure, the surgery will help you lose weight in two ways. First, your ability to take in large amounts of food will be limited because the size of your stomach will be roughly the size of a walnut after surgery. Second, you will not absorb some of the calories of the food you eat because it will bypass about 20 percent of the small intestine. Results vary, but generally patients can expect to lose 50 to 60 percent of their excess weight within the first two years after surgery.
Decline in Weight Loss Surgery Complications
Although the number of weight loss surgery procedures increased by 113 percent between 2001 and 2006, the rate of complications fell by 21 percent, according to William Encinosa, Ph.D., a Senior Economist at the Agency for Healthcare Research and Quality. In a report published in the May 2009 issue of “Medical Care,” he attributes this change, at least in part, to the increased use of laparoscopic procedures. Encinosa also notes, however, that the six-month death rate over the same time period remains the same, at about 0.5 percent, or about one in 200 procedures. In other words, although your risk for complications has decreased in recent years, your risk for death has not.
Inpatient Risks
All surgical procedures put the patient at risk for death, infection, bleeding, and reaction to anesthesia. During the initial hospitalization, according to the Mayo Clinic, patients undergoing gastric bypass are also at risk for rare but serious side effects, including death, blood clots in the legs, leaking at the stomach staple line, pneumonia, and narrowing of the opening between the stomach and the small intestine.
Long-Term Risks
Some problems can occur over time, according to the National Institutes of Health. Certain problems, including breakdown of the pouch; hernia at the incision site; or blockage of the opening between the stomach and small intestine, may require additional surgery. Problems related to nutritional deficiencies (iron, Vitamin B12, calcium, Vitamin D, and protein) and food intolerance (lactose deficiency and dumping syndrome) may be prevented by carefully following your surgeon’s instructions about food intake and dietary supplements. Other risks include heartburn; ulcers; vomiting; kidney stones; and depression. Unsatisfactory weight loss or weight regain occurs in about 10 percent of patients undergoing weight loss surgery, according to the National Institute of Diabetes and Digestive and Kidney Diseases. Sometimes this problem may be corrected surgically, or it may be related to lack of compliance with food and exercise plans.
About this Author
Marcy Brinkley’s articles about health care and legal issues have appeared in “Texas Health Law Reporter” and the “State Bar of Texas Health Law Section Report.” She holds a bachelor’s degree in nursing, a master’s degree in business administration and a Doctor of Jurisprudence.
