Roux-En-Y Gastric Bypass Anatomy and Concerns

by Peggy
(Orlando Florida )



I am considering the roux-en-y gastric bypass. I found it doing google searches, heard about it on the news, and it helps people like me lose weight… thank God there is something for us.

BUT… I am a bit of a hypochondriac. It might sound ridiculous, but how can I trust that my organs will be ok after surgeons actually cut them and open them up? When I read that the roux-en-y gastric bypass anatomy changes are permanent and can cause side effects, its making me nervous. My understanding is the stomach and intestines are modified and rerouted? “Digestive juices” go into your intestine?

I was wondering if you had any advice on how to reduce some of these fears about the roux-en-y gastric bypass before I make the decision of whether or not I want to get the surgery. I need an extra push to get this done. Totally sick of feeling bad in my own skin because I’m overweight, but literally terrified that surgeons will open my stomach and change my anatomy.

-Peggy Davenport

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by: John Rabkin, M.D., Pacific Laparoscopy


Weight loss surgery (WLS) does involve the surgical alteration of internal anatomy by cutting and sewing/stapling of internal organs along with, in some procedures, redirecting the food path. The overwhelmingly beneficial results of those interventions in patients with morbid obesity have been repeatedly demonstrated. The risks of an unintended injury to an internal organ or of surgery in general have similarly been proven to be minimal, although not non-existent. In order to quell any misgivings you have about proceeding with WLS, you should focus on the expected and anticipated benefits to your health and well-being that you will accrue from your WLS rather than the unlikely possibility of suffering an adverse outcome which you outline.

Currently there are four nearly universally accepted WLS procedures; some are more 'complicated' than others. You have chosen the Roux-en-Y Gastric Bypass (RYGB) procedure which is, by most estimates, the third most 'complicated' of the available accepted WLS procedures. The other three in order of 'complexity' are the Adjustable Gastric Band (AGB,) the Sleeve Gastrectomy (SG,) and the Duodenal Switch (DS.) You should become familiar with all four of these procedures so that you choose the optimal WLS for your particular situation. Your WLS provider(s) can help educate you as to the relative benefits and risks of each. However, ultimately, you should decide for yourself which WLS procedure to undergo based on your interpretation of the available information along with the expert counseling and guidance of your WLS provider(s.)

The RYGB may be the best WLS option for you once you've carefully considered all of your WLS options. However, if your focus is on simplicity of the procedure with minimization of the 'cutting on internal organs' and 'alteration' of your normal anatomy along with the avoidance of potential complications, you may be more comfortable proceeding with WLS if you choose to undergo a Sleeve Gastrectomy (SG) which only alters the actual stomach without affecting the intestines or the food path. The SG also is the least likely of the four WLS procedures to ever require 'reversal' of the WLS as the residual stomach capacity will enlarge over time. However, this fact, unfortunately, is also a major contributor to the potential of long term weight regain which, in a minority of SG patients' cases, requires re-visional (repeat) bariatric surgery to achieve durable (long lasting) weight loss.

The more information that you gather and consider about your upcoming WLS procedure, the less fear you'll experience and the more confidence you'll have in your decision to proceed with this life altering, life enhancing intervention. Let the WLS journey begin!

John Rabkin, M.D.
Pacific Laparoscopy


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DISCLAIMER: This educational advice is based on the depth of your question and the details provided. The above should never replace the advice of your local physicians as they have the ability to evaluate you in person.

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