The first step is easy.
Deciding to have surgery requires careful thought and discussion. Dr Andrew Kiyingi and his team can explain what each procedure involves & recommend the best one for you.
“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 athe 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:
In the first step, a small stomach pouch is created 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:
It reduces hunger
Your blood sugar control will improve – especially in type 2 diabetes sufferers
A reset in the body’s normal weight range which is often known as the set-point.
It’s Not Just Weight Loss.
It’s Health Gain.
Being overweight or obese is one of the leading risk factors for ill health in Australia. The longer you live with obesity, the greater the negative effect on your physical health, mental health and wellbeing.
Unfortunately, diets won’t work for many people and this is when bariatric surgery (also known as weight loss or obesity surgery) can help you achieve lasting results. These surgeries have continued to advance with research and technology and are safe and effective.
Surgery works by influencing hunger and the way in which the body process food/calories. It is expected that following weight loss surgery, a patient is able to eat every day normal healthy food (in a smaller quantity), participate in normal every day activities and enjoy a great quality of life.
Calculate Your BMI
- Under 18.5 – you are very underweight and possibly malnourished.
- 18.5 to 24.9 – you have a healthy weight range for young and middle-aged adults.
- 25.0 to 29.9 – you are overweight.
- Over 30 – you are obese.
Benefits & Risks of Roux En Y Gastric Bypass Surgery
There are many Benefits – Advantages of Roux en Y gastric bypass surgery includes:
It is expected to lose 70 – 80% of excess weight. Though many people 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.
Compared to lap gastric band surgery, patients can eat a variety of everyday food.
Nothing foreign is introduced (as with the gastric/lap band).
In studies, it is revealed that gastric bypass surgery is more effective than the gastric sleeve when comparing improvement/reduction of some obesity related conditions (like type 2 diabetes).
Some Risks – Disadvantages of Roux en Y bypass surgery include:
In the first 8 weeks of healing, there can be 1% risk of major bleeding or leakage from the staple line.
- It is more complex surgery to perform.
There is 5% risk of an internal hernia. This is twisting of the bowel and can be serious, requiring further surgery.
It is essential after bypass surgery to take their multivitamins as nutritional deficiencies can occur if this isn’t adhered to.
In a few cases, people will suffer from diarrhoea, abdominal discomfort, and feeling unwell after eating foods with high sugar.
After the pre-operative surgery programme, you are all set for a safe and successful surgery.
How to prepare yourself for surgery?
Try to relax and have a good night’s sleep the day prior to surgery.
Pay special attention to the fasting and diet instructions from our Bariatric Anaethetist.
Please note: Fasting includes no chewing gum.
Before surgery, you will again meet Dr. Andrew Kiyingi and his team. You are free to ask any additional questions at this point also.
Gastric bypass surgery is performed with keyhole (laparoscopic) procedure. It involves a few mall incisions on your abdomen.
A thin instrument called laparoscope (having a light and camera on the end), is inserted through one of the incisions, allowing Dr Andrew Kiyingi to view the internal organs on a TV screen.
Additional surgical instruments will be inserted through other incisions to complete the operation.
Initially, the stomach will be freed carefully from its surrounding organs.
If you have a hiatus hernia, Dr Kiyingi will then repair it before a stomach sizing guide (a bougie) is passed into your stomach to ensure accurate sizing of your new smaller stomach pouch.
Then the upper part of the stomach is converted into a smaller pouch through a stapling process. The remaining stomach is still present and remains healthy, however, does not receive food.
Dr Andrew Kiyingi will then measure and divide the small intestine into 2 sections where the lower part of the small intestine is then joined to the lower end of the stomach pouch. This allows food to take a short-cut, bypassing a portion of the small intestine.
In the final step, our team reconnects the upper part of the small intestine to allow any digestive juices from the bypassed stomach to mix with the food for normal digestion.
A special leak test is performed to ensure everything is performing correctly.
At the end of the procedure, the incisions are closed with dissolving sutures and covered with a waterproof dressing.
Our team will keep you comfortable with pain relief and anti-nausea medications.
It is advised to do some gentle walking and to avoid lifting.
Many patients feel very little pain after surgery. If you do, however, feel free to inform our health care team. We will try to make your stay as comfortable as possible.
You need to follow the diet advised by our specialist dietitian. In the beginning, this will include a clear liquid diet provided by the hospital.
Sweet or sugary diets should be avoided as this can make you feel unwell.
Dr Andrew Kiyingi will review you again and answer your questions at the time of discharge. You can take anti-acid medication and a twice-daily chewable multivitamin (BN Brand only) once you reach home.
After surgery, it is important to follow the dietary, protein, and fluid recommendations given by our specialist dietician and surgeon. Many patients take casual, comfortable walks each day. We know you have enough going on at this point of your recovery and generally suggest to hide the scales.
For Private Health Insurance, you may want to note the below MBS item number:
MBS Item Number: 31572 Laparoscopic Gastric Bypass
Cost of Roux En Y Gastric Bypass Surgery
There are 3 general categories available for funding gastric bypass as listed below:
Gastric Bypass under Private Health Insurance
Weight loss surgery including Gastric Bypass is generally available under most private health funds, only on their top or gold cover. If your cover is below the top cover you will need to upgrade your cover to the correct level and complete any required waiting period. Private health insurance provides you peace of mind that you will have full access to the private hospital sector if needed at at any stage during or after your surgery and the bulk of any fees will be covered by your private health insurer.
Self-Funding Gastric Bypass as an Uninsured Patient
Some patients may choose to self-fund the full cost of the gastric bypass from their own resources. Due to the complexity of gastric bypass surgery this funding option is generally not recommended. Dr Andrew Kiyingi will determine if this option is available to you or not depending on your medical assessment
Self-Funding Gastric Bypass with Early Superannuation Release
Similar to self-funding uninsured patients, some patients may access superannuation to fund their gastric bypass surgery. However, if any unforeseen circumstance were to arise, these patienst have difficulty accessing the private hospital system as they would be uninsured. As such Dr Andrew Kiyingi will determine if this funding option is suitable for your depending on your medical assessment.
Dr. Andrew Kiyingi (MSurg FRACS)
General Surgeon and Bariatric Surgery Specialist
Dr Kiyingi is a Specialist Weight-loss and General Surgeon with advanced training in minimally invasive surgery with over 16 years clinical experience. He is also a Surgical Trainer for the Royal Australasian College of Surgeons.
Dr Andrew Kiyingi was schooled in Sydney, graduated from the University of Otago (NZ) and was awarded the University Gold Medal in General Practice and Distinction in Surgery. He completed surgical training at St Vincents Hospital Melbourne and was awarded Fellowship (FRACS) under the Royal Australian College of Surgeons.