Surgical Options

RNY Gastric Bypass

Offered at BIDMC

The most common gastrointestinal weight loss surgery performed in the U.S. is the Roux-en Y Gastric Bypass (RYGB). In a traditional or "open" RYGB, a large incision is made into the abdomen. Or, with the laparoscopic technique, several small incisions are made. A laparoscope is connected to a video camera and is inserted through the incisions. The physician is then able to perform the procedure viewing the internal organs on a television monitor.

In both open and laparoscopic Roux-en-Y bypass, the stomach is divided by creating a small pouch, which is closed by several rows of staples. The remaining portion of the stomach is not removed but is "bypassed" and plays a diminished role in the digestive process. A Y-shaped portion of the small intestine is then attached to the pouch. The pouch is capable of holding approximately one ounce. Weight loss occurs as a result of reduction of calories, alteration in gut appetite hormones, and decreased nutrient absorption.

In addition to its safety benefits, proven advantages include significant weight loss, improvement in obesity related health issues and a quicker recovery time.

As with all surgical procedures, there are some risks associated with bariatric surgery. Complications, which may occur with the Roux-en-Y Gastric Bypass, include:

  • stomal obstruction (5-15% of patients)
  • postoperative bleeding (1-5% of patients)
  • small bowel obstruction (1-3% of patients)
  • gastrointestinal leak (1-3% of patients)
  • deep vein thrombosis (1-2% of patients)
  • spleenectomy (1% of patients)
  • pulmonary embolus (0.5% of patients)
  • death within 30 days (0.5-1% of patients)
  • protein-calorie malnutrition ( <1% of patients)

Information has been taken from the Massachusetts Expert Panel on Weight Loss Surgery Summary from the Betsy Lehman Center for Patient Safety and Medical Error Reduction within the Department of Public Health. 

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