Gastric bypass surgery is the primary surgical procedure done at the Weight and Wellness Center. For people with class 3 severe obesity, defined as high-risk or a BMI over 40, gastric restrictive surgery may offer the best long-term solution.
A minimally invasive procedure with long-term results
The Roux-en-Y (RNY) is considered 'the Gold Standard' for Gastric Bypass surgery. During this operation, the surgeon separates the stomach into two sections with a special stapling device. This creates a small working section on top (called a pouch) connected to the esophagus. This pouch will become the new stomach and is constructed to contain only 1 ounce of food.
The rest of the stomach is completely disconnected from the pouch and remains where it normally is but no nutrients enter it. It is alive and healthy and still secretes acids and other gastric juices, which flow into the intestines to aid in digestion. It also continues to make intrinsic factor (necessary to absorb Vitamin B12) and contributes to hormone balance and motility of the intestines in ways that are not entirely known. In some cases it may shrink a bit and its lining (the mucosa) may contract, but for the most part it remains unchanged.
The new pouch is then stapled to a segment of the intestine so that the food travels from the mouth, down the esophagus through the pouch directly into the intestine, bypassing the majority of the 'left over' bottom section. Inside this new connection between the pouch and the intestine, a small 'hole' or 'tunnel' is created for the food to pass through. This 'hole' is called a stoma and is deliberately made very small in diameter (picture a drinking straw) to slow down the movement of food from the pouch out into the intestine.
What to expect on your day of surgery
How weight loss is achieved with RNY
This weight loss operation produces a number of changes in how your body digests food. These changes, in combination with an overall plan of diet and exercise, can help you lose a significant amount of weight in several ways:
- You now have a smaller stomach. The small "pouch" created during the operation is your new stomach. It can only hold about 3 ounces of food or liquid at a time. (Normally, the stomach can hold up to 50 ounces.) A much smaller stomach means it takes a much smaller amount of food to make you feel full.
- Slower digestion. Because of the small opening connecting the pouch to the intestines (the stoma), food moves through the system very slowly after it is eaten, making you feel full longer.
- Hormone changes. Your body makes hormones that contribute to your feeling full after a meal. The changes in the way food enters the intestines after surgery affects these hormones, which may also help you feel full for a longer period. Hormone changes are also responsible for the "dumping syndrome" - a side effect of surgery that is explained below, but that can also contribute to rapid weight loss in the months following surgery.
The Weight and Wellness Center team often recommends the gastric bypass technique for eligible patients who have decided to have weight loss surgery. We are one of the top centers for gastric bypass surgery in Boston and have performed over 2,500 gastric bypass surgeries. Along with our strong expertise, we offer patients a number of resources including a mentor program and gastric bypass support groups.