Laparoscopic Roux En Y Gastric Bypass

What Is Laparoscopic Roux en Y Gastric Bypass?

This gastric bypass surgery procedure is also done via the laparoscopic or keyhole technique. A small pouch of upper stomach is created and separated from the rest of the stomach using specially designed surgical staplers. This allows the patient to eat a small amount.

Food is then directed further down the path of the small intestine. The length of intestines left to absorb calories is shorter causing a certain degree of malabsorption and reducing the amount of calories and nutrients absorbed.

Why Laparoscopic Roux en Y Gastric Bypass?

Bariatric surgery procedures are recommended for long-term weight loss and improvement of obesity-related medical problems such as diabetes, hypertension and high cholesterol (also known as the metabolic syndrome). If you have problems with the amount of food eaten, Laparoscopic Roux en Y Bypass may be a good option for you.

What to expect?

Before your weight loss surgery

  • In preparation for your bariatric surgery, a gastroscopy is done to ensure the stomach does not have any disease.
  • A full medical mark-up including an ultrasound of the liver and gallbladder is done.
  • Fasting is required 8 hours prior to your gastric bypass procedure.
  • All regular medications will be stopped unless absolutely necessary under a doctor’s supervision.
  • Be prepared to have an average hospital stay following the procedure in between 2-3 days.

On the day of your bariatric surgery procedure

  • Be prepared to have an average hospital stay following the procedure in between 3-5 days.
  • A laparoscopic bypass procedure is reversible, however, surgically reversing this procedure is a technically demanding procedure.
  • There will be 5 small wounds used to perform the procedure.
  • Your surgeon will advise you on the specific details.

After the gastric bypass surgery

  • You will be allowed to drink fluids and eat within the next 24 hours. However, allow your appetite to guide you. Fluid diet is required for the first week.
  • If you experience nausea, stay with clear liquids until it resolves.
  • Resume your normal diet after about a week and after the first review with your doctor.
  • The amount of food consumed will be small and has to be taken slowly.
  • Your doctor will advise on the type of food to be consumed, and encourage you to embark on an exercise regime after a month.

Why laparoscopic roux en y bypass?

For the severely obese, it is often difficult to achieve significant and sustained weight loss via conventional methods of diet and exercise. If you are very overweight, you are at higher risk of having diseases related to obesity such as Type II diabetes, metabolic syndrome, high blood pressure, high cholesterol and sleep apnea amongst others.

Laparoscopic roux en y bypass is highly recommended as a safe and effective method to help you lose a significant amount of weight and sustain it in the long-term. In addition to weight loss, this procedure offers numerous health benefits and helps you resolve or improve obesity-related diseases.

Significant and sustained weight loss

Laparoscopic roux en y gastric bypass helps a person lose around 65 per cent of excess weight over six months to a year and keeping at least 50 per cent of the initial weight loss off. Studies have shown that long-term weight loss is sustained even after 5, 10 and 15 years.

This weight loss makes the patient feel better, have greater mobility and have a better quality of life. Individuals report greater confidence and improved self-esteem that comes with weight loss. Surgery enables them to learn to make healthier food choices and accomplish goals they set for
themselves in terms of their health.

Improving or resolving obesity-related diseases

Not only does laparoscopic roux en y bypass help in weight loss, the surgery improves or resolves more than 40 conditions which are linked to obesity by 75 per cent. It reduces mortality rate from cancer by 60 per cent, Type II Diabetes by 90 per cent and coronary artery disease by 55 per cent.
Laparoscopic roux en y gastric bypass is especially effective in treating Type II Diabetes, causing reversal or improvement of diabetes in 86 per cent of patients and remission in 78 per cent of patients. Most diabetic patients have an almost immediate reduction in the required dosage of diabetic medication This procedure also lowers the risk of high blood pressure, high cholesterol, sleep apnea and stops acid reflux.

Most of the obesity-related comorbidities were improved or resolved one year after the procedure and 95 per cent of patients reported significant improvement in their quality of life.

Low risk of complications

Laparoscopic roux en y gastric bypass has an extremely low rate of morbidity, mortality and complications during the operation and in the long run, as well as a shorter hospitalisation stay and quicker recovery time compared with the traditional method of open surgery.

For these reasons, laparoscopic roux en y gastric bypass is the bariatric procedure of choice for most patients who are clinically severely obese.

Am I suitable for laparoscopic roux en y bypass?
Laparoscopic roux en y bypass is recommended if you are severely overweight, having either a:

  • Body Mass Index (BMI) of over 40 or
  • BMI between 35 and 40 with health conditions such as Type II diabetes, metabolic syndrome,
    heart disease or sleep apnea

This surgery is advised especially if you have attempted conventional methods of weight loss such as diet and exercise but are unsuccessful in losing significant weight loss in the long run.

How will my diet be like after laparoscopic roux en y gastric bypass?

You will feel full early and feel satisfied more quickly after consuming small meals. Your appetite will be reduced and you will eat around 25 per cent of what you used to eat before. You may feel full after eating an appetiser at a restaurant. The key thing is that a small meal naturally leaves you satisfied without you making a conscious effort to do so makes the experience different from dieting. In this way, your weight loss will be sustainable in the long run via eating a variety of healthy food.

Laparoscopic roux en y gastric bypass is particularly effective if you are someone who likes to eat foods which are high in sugar and fat. Following surgery, sweet and fatty foods are poorly tolerated by your body and best avoided. Dumping syndrome will occur when you consume these foods as a
result of the rapid presence of high osmolality fluid in the small intestine. You may experience abdominal discomfort, nausea, sweating, dizziness and palpitations. These unpleasant symptoms will discourage you from consuming sweet and fatty foods which are often high in calories, assisting in weight loss.

You are likely to be given multivitamins, calcium supplements, Vitamin B and iron supplements by
your doctor or nutritionist. These are often required and extremely important to good health.

What lifestyle changes should I make after laparoscopic roux en y gastric bypass?

It is important to note that you need to commit to behavioural changes such as adopting a healthy diet and participating in regular exercise and other recommendations your doctor has suggested in order to maintain your weight loss.

This procedure does not require on-going adjustments unlike other procedures. However, regular follow-ups with your doctor is necessary to ensure your weight loss is suitable and at an appropriate pace. Your doctor or nutritionist will ensure you are taking in sufficient nutrients,
vitamins and supplements as well.


If you need laparoscopic bypass surgery in Singapore, contact us for your options.

Schedule a consult with our doctor Dr Ganesh Ramalingam

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