Our Team @ Instituto Bariátrico | Dr. Luis A. Betances P., CEO, General, Laparoscopic & Bariatric Surgeon, Santo Domingo, Dominican Republic

Dr. Luis A. Betances

Bariatric Surgeon

Roux-en-Y gastric bypass, RYGB

Roux-en-Y Gastric Bypass: A Gold Standard in Bariatric Surgery

Roux-en-Y Gastric Bypass (RYGB) is one of the most commonly performed and well-established procedures for treating obesity and its associated conditions. This surgery has been regarded as the “gold standard” for bariatric surgery due to its efficacy and long-term outcomes in weight loss and metabolic improvements.


What Is Roux-en-Y Gastric Bypass?

RYGB is both a restrictive and malabsorptive surgical procedure. It involves two major steps:

  1. Creation of a Small Gastric Pouch: The stomach is divided to form a small pouch, which reduces food intake significantly.
  2. Bypassing Part of the Small Intestine: The small intestine is restructured into a Y-shaped configuration, where the gastric pouch is connected to a lower section of the small intestine, bypassing the duodenum and part of the jejunum. This limits calorie and nutrient absorption.

This dual mechanism facilitates significant weight loss and improves metabolic health.


Benefits of Roux-en-Y Gastric Bypass

RYGB is highly effective in addressing obesity-related health concerns, such as:

  • Type 2 Diabetes: The procedure often leads to immediate improvement in blood glucose levels, even before significant weight loss occurs.
  • Cardiovascular Health: Improvements in blood pressure, cholesterol levels, and reduction of cardiovascular risk factors are commonly observed.
  • Sleep Apnea: Many patients experience relief from obstructive sleep apnea symptoms post-surgery.
  • Long-Term Weight Loss: Studies show that patients maintain 60–80% excess weight loss over 10–15 years.

Risks and Complications

As with any major surgery, RYGB comes with potential risks and long-term considerations:

  1. Surgical Risks: Complications such as bleeding, infections, or anastomotic leaks can occur.
  2. Dumping Syndrome: Rapid emptying of stomach contents into the small intestine can lead to symptoms like nausea, cramping, and diarrhea.
  3. Nutritional Deficiencies: The bypassed section of the small intestine reduces absorption of essential nutrients like iron, calcium, and vitamin B12, requiring lifelong supplementation.
  4. Bowel Obstruction: Adhesions or narrowing at the surgical sites can lead to obstruction and may require further intervention.

Eligibility for Roux-en-Y Gastric Bypass

Candidates for RYGB typically include:

  • Individuals with a BMI of 40 or greater.
  • Those with a BMI of 35–40 accompanied by obesity-related comorbidities like type 2 diabetes or hypertension.
  • Patients who have failed to achieve sustainable weight loss through non-surgical interventions.

Postoperative Lifestyle Requirements

To achieve the best results, patients must commit to:

  • Dietary Modifications: Transitioning from liquids to solid foods gradually and maintaining a high-protein, low-sugar diet.
  • Lifelong Supplementation: Daily vitamins and minerals, including multivitamins, calcium, and iron, are essential.
  • Regular Medical Follow-Up: Routine monitoring of nutritional and metabolic health is necessary.
  • Physical Activity: Regular exercise is encouraged to maintain weight loss and improve overall health.

Roux-en-Y Gastric Bypass vs. Other Bariatric Procedures

RYGB is often compared to other bariatric surgeries, such as sleeve gastrectomy or OAGB. While sleeve gastrectomy is simpler and carries fewer risks of nutritional deficiencies, RYGB generally provides more effective and sustained weight loss. Compared to OAGB, RYGB has a lower risk of bile reflux but involves a more complex surgical procedure.


Advantages of Roux-en-Y Gastric Bypass

  • Proven Efficacy: Long-term success in achieving significant weight loss.
  • Metabolic Benefits: Superior improvement or remission of type 2 diabetes and other metabolic disorders.
  • Durable Outcomes: Sustained weight loss over decades.
  • Comorbidity Resolution: Improvements in obesity-related conditions like hypertension, sleep apnea, and joint pain.

Roux-en-Y Gastric Bypass remains an excellent option for those seeking long-term solutions to severe obesity and its related health issues. It requires a strong commitment to lifestyle changes and regular medical follow-ups, but its advantages in transforming health and quality of life are substantial.

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Procedures
Mini gastric bypass
Sleeve gastrectomy
Gastric Sleeve Plication
Biliopancreatic diversion
Intragastric balloon

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Dr. Luis A. Betances, cirujano bariátrico | Medii

Dr. Luis A. Betances

Bariatric Surgeon

Instituto Bariátrico Dr. Luis A. Betances | Medii
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