What happens to the lower part of the stomach that is bypassed in RNY gastric bypass?
In gastric bypass, the stomach is left in place with intact blood supply and remains unchanged. It does not receive food but contributes secretion to aid digestion.
How big is the incision and is there much pain?
Pain is minimal and generally controlled with acetaminophen. The laparoscopic incisions are typically very small. On average, four to six incisions are made for the medical devices to be used. Most patients recover in a shorter time and have a lower chance of wound complications (e.g. infection, hernia) than in an open surgical procedure. Some return to work in little more than a week and many quickly return to physical activity. Patients generally have very small scars and report a feeling of having “performed many sit ups.” Some discomfort from gas pain is common after surgery.
What will the staples do inside my abdomen? Is it okay in the future to have an MRI test? Will I set off metal detectors in airports?
The staples used on the stomach and the intestines are very tiny in comparison to the staples you will have in your skin or staples you use in the office. Each staple is a tiny piece of stainless steel or titanium so small it is hard to see other than as a tiny bright spot. Because the metals used (titanium or stainless steel) are inert in the body, most people are not allergic to staples and they usually do not cause any problems in the long run. The staple materials are also non-magnetic, which means that they will not be affected by MRI. The staples will not set off airport metal detectors.
Is there any difficulty in taking medications?
Typically you should be able to take most medication as before your surgery. Your team will review your medication plan with you.
Most people are able to take a decreased amount of medications as their health improves.
How fast do you lose weight?
Weight loss after bariatric surgery varies from person to person. Typically, a patient will lose weight quickly after the first few months and then the pounds will come off more slowly. It usually takes about 12 to 18 months to achieve maximum weight loss.
Will I be asked to stop smoking?
Patients MUST stop smoking at least two months before surgery. Smoking increases the risk of all complications after surgery. We can refer you to a smoking cessation program to help you achieve this. Please contact us and ask for this referral if you need it.
What can I do to prevent lots of excess hanging skin?
As we age, skin elasticity decreases, which can result in excess skin folds after weight loss. The amount of loose skin is variable among individuals.
Some patients will choose to have plastic surgery to remove loose or excess skin after they have lost their excess weight. Insurance generally does not pay for this type of surgery (often seen as elective surgery). However, some do pay for certain types of surgery to remove excess skin when complications arise from these excess skin folds. Ask your surgeon about your need for a skin removal procedure.
Will exercise help with excess skin?
Exercise is an important part of maintaining your weight loss. Its effect on excess skin is variable.
Will I have to change my medications?
Your doctor will determine whether medications for blood pressure, diabetes, etc., can be stopped when the conditions for which they are taken improve or resolve after weight loss surgery. For meds that need to be continued, the vast majority can be swallowed, absorbed and work the same as before weight-loss surgery.
Two classes of medications that should be used only in consultation with your surgeon are diuretics (fluid pills) and NSAIDs (Non-Steroidal Anti-Inflammatory Drugs), which are most over-the-counter pain medicines. NSAIDS (ibuprofen, naproxen, etc.) may create ulcers in the small pouch or the attached bowel.
What is the risk of a blood clot?
Any type of surgery and obesity are risk factors for formation of blood clots — deep vein thrombosis (DVT) or pulmonary embolism (PE). These blood clots can form in the lower extremities (DVT) and travel to the lung (PE). The best way to avoid blood clots is prevention through:
- Early mobility after surgery
- Inflatable compression stockings while in the hospital
- Blood thinners in the hospital
It is important also to be active at home once you are discharged.