12 Things You Should Know About RNY Gastric BypassJune 3, 2016
Once you decide to pursue a bariatric weight loss solution, whether it is the RNY Gastric Bypass or any other surgical procedure, you will have an important conversation with your surgeon about which procedure will ultimately help you lose the most weight as safely as possible. This will be determined by examining a list of parameters that includes your current weight, overall health, current medical conditions, your age and your post-op lifestyle after the operation.
RNY Gastric Bypass
With the RNY Gastric Bypass, the most common gastric bypass surgery, a small part of the existing stomach is used to create a new stomach pouch, which becomes about the size of a golf ball, which is nearly 90 percent smaller than the original stomach. This new, smaller stomach is connected directly to the middle portion of the small intestine (jejunum), bypassing the rest of the stomach and the upper portion of the small intestine (duodenum).
Rerouting the food stream in this manner produces changes in gut hormones that promote satiety (feeling full), suppresses hunger, and reverses one of the primary mechanisms which promotes the onset of type 2 diabetes.
12 Things To Know About the RNY (Roux-en-Y) Gastric Bypass
I’ve performed hundreds of Roux-en-Y gastric bypass operations and would like to share 12 key facts about this surgical bariatric weight loss option:
1. The degree of weight loss for RNY: The RNY is a more complicated surgical procedure but offers a greater degree of weight loss compared to the sleeve gastrectomy or adjustable gastric banding. No lifelong adjustments are needed (as with the Lap-Band) and many patients also report a decrease in the frequency and intensity of cravings for foods high in sugar and fat. Many surgeons prefer gastric bypass surgery because it generally has fewer complications than other WLS operations.
2. Bariatric support groups: Joining a bariatric support group before your operation will reduce stress and help you prepare for your post-op lifestyle change. Meet, talk with and listen to other people who have already traveled the path you are about to take. Take notes, ask questions and create a pre-op ‘to-do’ list before you go into the hospital. Continue participating in the group after your procedure and offer advice to people who come after you in the bariatric process. Planning and education will help lessen stress before and after your surgery.
3. Understand RNY Gastric Bypass pitfalls: As with any operation, there are risks and possible complications. Discuss these issues with your bariatric surgeon and nutritionist. Understand what post-op complications might be and their symptoms.
4. Risks of the RNY Gastric Bypass: The risks of gastric bypass surgery are low, particularly when compared to the health risks of metabolic syndrome (obesity). The safety of all bariatric procedures have improved over the years thanks to improved technology and the less invasive nature of many operations; the American Society for Metabolic and Bariatric Surgery (ASMBS) reports that the chances of having a significant surgical complication are less than five percent. Comparatively, the risks of staying obese and facing heart disease, type 2 diabetes, hypertension and sleep apnea, are far more hazardous.
5. How to avoid weight regain: You can regain weight if you don’t follow the RNY post-op protocol. Gastric bypass surgery is not a miracle operation; it's a tool to help you overcome the situation you are now facing--living with significant obesity that could exacerbate life-threatening health complications. If you abuse your “new stomach" by not following the nutrition plan, taking vitamins, drinking water or moving your body regularly, your surgery could be in jeopardy of failure. (This is also true for all bariatric operations).
6. Protein, protein, protein: Consuming enough protein into a post-op diet can be challenging. Protein is your body’s new best friend. Make sure you get enough -- if not, you will start feeling ill. Protein drinks are commonly consumed by many patients or added to prescribed recipes when eating solid protein is too challenging.
7. Your bathroom habits will change: About 85 percent of patients who undergo RNY surgery will experience some form of diarrhea (dumping syndrome) after surgery, according to the ASMBS. It's usually the result of poor food choices (eating refined sugars, fried foods, and some fats or dairy). As long as you eat as prescribed, you will avoid this unpleasantry.
8. Eat only when you are really hungry: For the first few weeks after surgery, you will be eating no more than a 1/4 cup of food per meal. After a few months, you may get up to one cup of food per meal, maximum. The surgery will leave you unable to eat at some typical meal times so listen to your body; don’t eat “just because…” Maintain hydration by sipping water (aim for two liters/day) throughout the day.
9. Watch out for signs of post-op depression: As with any surgery, the mind, body and spirit are affected after gastric bypass WLS. During the course of recovery and onset of rapid weight loss, patients should be keenly aware of any signs of depression: lack of interest in previously enjoyable activities, social isolation, sleeping too much or too little, no motivation to get up and out, feeling hopeless. Depression is a disease for which there is treatment. Contact your family physician or bariatric surgeon for support and guidance if depression symptoms appear.
10. Take your prescribed vitamins: Your surgeon or bariatric nutritionist will prescribe a regime of bariatric vitamins for you to take which will compensate for your reduced food intake. I also prescribe an extra iron and calcium pill as well.
11. Keep up with your lab visits: During your first year after surgery, you'll have routine lab work done at six weeks, three months, six months and a year after surgery. The second year, you'll only need labs done every six months.
12. Most people say they wish they had undergone the surgery sooner: Most people say that if they could go back in time, they'd choose to have WLS again. Why? Bariatric surgery patients reported they feel markedly better, have much more energy, are more active, take fewer medications (due to obesity-related medical conditions) and simply “enjoy life more fully.”
A Life-Changer: RNY Gastric Bypass
WLS starts the process of a long-term lifestyle change. It opens the door to improved health, appearance and longevity. But it’s not a miracle surgery—patients have to do the work by following the nutrition plan, staying well hydrated, consuming the necessary amount of protein and exercising regularly.
Will there be occasional roadblocks after Roux-en-Y (RNY) Gastric Bypass? Certainly. But these are only temporary bumps in the road on a long and fruitful journey to a healthy and happy life.
ABOUT THE AUTHORDr. Ayotunde Adeyeri is a New Jersey board certified, fellowship-trained, advanced laparoscopic, bariatric and general surgeon. He is the Medical Director of Sterling Surgicare in Holmdel, NJ, and Co-Medical Director of Central Jersey Bariatrics in Freehold. He specializes in performing a wide range of bariatric procedures including RNY gastric bypass, sleeve gastrectomy, duodenal switch (DS), gastric banding and revision bariatric surgery.
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