“Weight loss (Bariatric) Surgery has significant health benefits such as reducing the risk of death from many causes. It is important to maintain a healthy lifestyle even after surgery”
Roux en Y Gastric Bypass Surgery (abbreviated to RNY) has been considered in the past as the gold standard weight-loss operation with over 40yrs of research. It has been around longer than the gastric band, gastric sleeve and mini-gastric bypass. It is a very effective operation for weight-loss but also treating reflux (heartburn) and for this reason, the operation is longer and more complex than the others.
This keyhole (laparoscopic) procedure involves 2 main steps:
The first is creating a small stomach pouch using a surgical stapler. This is slightly smaller than the gastric sleeve and mini-gastric bypass. As a result, the stomach size becomes much smaller allowing you to feel full after eating only a small meal.
The second step is to rejoin the small intestine to allow the food to essentially take a short-cut through the small intestine and also rerouting the digestive juices away from the stomach pouch. As a result, fewer calories are absorbed during digestions and reflux is treated.
The Roux en Y gastric Bypass also has a significant effect on a range of digestive hormones. This results in:
Improved blood sugar control particularly in people with type 2 diabetes
A reset in the body’s normal weight range which is often known as the set-point.
Following the completion of the pre-operative surgery programme everything will be in place for safe and successful surgery. It is natural to be anxious on the day of surgery. Rest assured that Dr. Andrew Kiyingi has a reputation as a meticulous surgeon. Try to have a light and relaxed schedule the day prior to surgery and good night sleep. Please pay extra special attention to the diet and fasting instructions from our Specialist Bariatric Anaethetist. It’s important to note that fasting includes no chewing gum.
On the day of surgery, you will be again greeted by Dr. Andrew Kiyingi and his Specialist Anaethetist. Please feel free to ask any additional questions. The procedure is performed under general anaesthesia. The key-hole (laparoscopic) procedure involves making 6 small incisions (2cm) on your abdomen. Carbon dioxide gas will be used to expand your abdomen, allowing the organs to be seen. A special narrow camera called a laparoscope, will be inserted through one incision and a video image will be relayed to a tv screen to allow Dr. Andrew Kiyingi to perform the surgery. Further small instruments will be inserted through the other incisions as required to complete the operation. During surgery your liver will be gently lifted up to reveal the stomach. The stomach will then be carefully freed from its attachments and surrounding organs. Dr. Andrew Kiyingi will assess if you have a Hiatus Hernia defect and repair it if required (read more here). A stomach sizing guide called a bougie will then be passed into your stomach. This bougie ensures consistent and accurate sizing of your new smaller stomach pouch. Dr. Andrew Kiyingi with then carefully staples along this sizing guide ensuring that each staple forms a tight seal. This stapler will divide the old stomach from the new smaller stomach pouch. The old stomach is not removed and remains healthy in the abdomen but does not receive food.
Dr. Andrew Kiyingi will then accurately measure the small intestine and determine the appropriate length to bypass (usually 150 – 200cm). The small intestine will then be divided into 2 sections. The lower part of the small intestine is then joined to the lower end of the stomach pouch. This becomes the new pathway for your food from the small stomach pouch, allowing the food to essentially take a short-cut through the small intestine. The final step involves reconnecting the upper part of the small intestine to allow any digestive juices from the bypassed stomach to mix with the food for normal digestion to continue while avoiding reflux.
A special leak test is then performed to ensure everything is secure. Dr. Kiyingi will then apply special local anaesthesia to minimise any discomfort following surgery.
At the end of the procedure, the incisions are closed with dissolving sutures and covered with a waterproof dressing. The operation will be complete when you wake up and you will stay in the recovery unit for some time till you are ready to return to the surgical ward. It is common to feel tired after surgery.
Roux en Y Gastric Bypass After Care
Roux en Y Gastric Bypass After Care
You will be kept comfortable with pain relief and anti-nausea medications and encouraged to do some gentle walking. Many of will generally report very little pain following surgery. Please feel free to inform the health care team if there is any way in which we can make your stay more comfortable
The after-surgery diet information will have already be provided to you by our specialist dietician. Initially this will involve a clear fluid diet provided by the hospital. Some patients prefer to also bring some additional drinks of their choice. A sweet or sugary diet should be avoided as this can make you feel unwell.
Dr. Andrew Kiyingi will review you again when it’s time for discharge and answer any of your questions. Once you arrive home you can begin taking your anti-acid medication and your twice-daily chewable multivitamin (BN Brand only).
It is will be important to follow the dietary, protein and fluid advice provided by our specialist dietician and surgeon. Many patients enjoy causal comfortable walks each day. We know that you will have enough on your mind at this part of your recovery and we generally recommend hiding your scales for now.
MBS Item Number: Laparoscopic Gastric Bypass
MBS Item Number: Laparoscopic Gastric Bypass
For Private Health Insurance, you may want to note the below MBS item number:
MBS Item Number: 31572 Laparoscopic Gastric Bypass
Benefits & Risks of Roux En Y Gastric Bypass Surgery
There are many Benefits – Advantages of Roux en Y gastric bypass surgery includes:
70 – 85% Excess weight loss expected. Many however will exceed this.
Roux en Y Bypass surgery is the most effective treatment for reflux (heartburn) compared to other weight-loss surgeries including the mini gastric bypass.
Patients can eat a wide variety of normal everyday food choices compared to lap gastric banding.
No foreign material is implanted such as gastric band.
Studies reveal it is more effective than the gastric sleeve in the improvement or remission of some obesity-related conditions such as type 2 diabetes.
Some Risks – Disadvantages of Omega loop bypass surgery include:
1% risk of major bleeding or leakage from the staple line during the first 8 weeks of healing.
- It is a longer and more complex surgery to perform
5% risk of twisting of the bowel called an internal hernia. This can be serious, requiring further surgery.
Nutritional deficiencies can occur particularly if someone does not take their multivitamins. This is particularly important following bypass surgery.
In some cases, foods high in sugar may lead to abdominal discomfort, diarrhoea and feeling unwell sometimes known as dumping.
Cost of Roux En Y Gastric Bypass Surgery
“During your consultation our Practice Manager will outline the cost involved for surgery and aftercare.”
If you are Privately Insured, it is important to contact your private health insurer to check that your level of cover is adequate for the item numbers we have listed below. Generally, you will require top level or gold cover and should have completed the waiting period. Medicare cover only a small portion of the surgery fees.
If you are Uninsured, we are still happy to proceed with surgery. However, we will receive a separate quote from the hospital for your private hospital stay. Our practice manager will discuss this during your appointment.
Some patients choose to utilise early access of Superannuation funds. These may be privately insured patients who may use Superannuation to cover any fees or gaps not covered by their insurance, or uninsured patients who may use Superannuation to cover the full surgery programme amount. We are happy to support in this depending on your circumstances.