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Gastric bypass surgery- Roux-en-Y (RNY)

gastric bypass surgeryPrior to any weight loss operation, particularly Gastric Bypass, your physician will give you a complete medical examination and evaluate your overall health. You will also receive extensive nutritional counseling before and after your surgery. This surgery is performed under general anesthesia.

The Roux-en-Y Gastric Bypass Surgery is performed in two steps:

Step One

The first step in this surgical procedure makes the stomach smaller. Dr. Quesada divides the stomach into a small upper section and a larger bottom section using staples that are similar to stitches. The top section of the stomach (called the pouch) will hold a patient's food.

Step Two

After the stomach has been divided, Dr. Quesada connects a section of the small intestine to the pouch. He then reconnects the base of the Roux limb with the remaining portion of the small intestines from the bottom of the stomach, forming a y-shape. Now, when a patient eats the food will travel from the pouch through this new connection ("Roux limb"), bypassing the lower portion of the stomach. The "y-connection" allows food to mix with pancreatic fluid and bile, aiding the absorption of important vitamins and minerals.

While all malabsorptive operations carry a risk for nutritional deficiencies, the Roux-en-Y Gastric Bypass procedure carries less risk than surgeries that bypass the duodenum and the jejunum (Biliopancreatic Diversion).

Laparoscopy

Dr. Quesada performs the Roux-en-Y Gastric Bypass using a laparoscope. This less-invasive technique allows him to make small (less than one half inch) incisions, which lowers the risk of large scars and hernias after the procedure.

To perform this laparoscopic procedure, small incisions are made in the abdomen. The doctor then passes slender surgical instruments through the narrow openings, and a camera (laparoscope) is then passed through. Dr. Quesada utilizes a lens and video monitor as he peforms the surgery.

The normal hospital stay for Gastric Bypass Surgery is one night, and patients are discharged after Dr. Quesada examines them and they can do the following:

  • Move without too much discomfort
  • Eat liquid and/or pureed food without vomiting
  • No longer require pain medication given by injection

Patients remain on liquid or pureed food for several weeks after the surgery, and even after that time will feel full very quickly, sometimes only being able to take a few bites of solid food. This is because the new stomach pouch initially only holds a tablespoonful of food. The pouch will eventually expand, however it will hold no more than about one cup of thoroughly chewed food (a normal stomach can hold up to one quart).

After having gastric by-pass surgery, patients should eat small meals frequently throughout the day, rather than large meals that their stomach cannot accommodate. The new, smaller stomach also will not tolerate large amounts of fat, alcohol, or sugar. Patients should reduce fat intake, especially fast food meals, deep-fried foods, and high-fat foods, as well as high-sugar foods like cakes, cookies, and candy.

Exercise and the support of others (for example a support group comprised of people who have undergone weight loss surgery) are extremely important to help patients lose weight and maintain that loss following gastric bypass. Patients can generally resume exercise 6 weeks after the operation and, even sooner, will be able to take short walks at a comfortable pace, with the approval and guidance of the doctor.

The risks of gastric bypass surgery include: bleeding, infections, follow-up surgeries to correct complications, or to remove excess skin, gallstones due to significant weight loss in a short amount of time, gastritis (inflammation of the lining of the stomach), vomiting from eating more than the stomach pouch can hold, iron or vitamin B12 deficiencies (if they occur) can lead to anemia, calcium deficiency (if it occurs) can contribute to the development of early osteoporosis or other bone disorders. Follow up surgeries are less likely because gastric bypass is performed with a laparoscope.

 

Dr. Quesada performs his surgeries at the following hospitals in San Jose, Costa Rica:


Hospital Clínica Bíblica CIMA Hospital Metropolitan Hospital


CIMA Hospital

CIMA Hospital is JCI accredited, an international mark of quality in medical and health care. It is run by International Hospital Corporation, Dallas Texas.

The top management of the hospital are all Americans. Costa Rican doctors, surgeons, physicians, and dentists who practice at CIMA undergo stringent credential check put in place by the CIMA management.

CIMA Hospital in San Jose is the only hospital in Central American that is accredited by the Department of
US Veterans Affairs. CIMA Hospital has made Costa Rica the safest destination for health tourism in Central America.

Metropolitan Hospital

Metropolitan Hospital is a new hospital located in San Jose.  It offers the latest and best in medical technology.  It is US accredited (AAAHC).  This mid-sized hospital is now recognized internationally as a hospital that meets the highest standards for management quality and safety.  

Metropolitan Hospital offers an excellent mixture of high technology, professional ethics, and human resource committed to the welfare of their patients.

 

The cost of the RNY or the MGB Gastric Bypass is $8,500 to $10,000, depending on which hospital you choose to have your surgery performed in. This includes: pre-op testing, consultation, surgeon fees, operating room, anesthesiologist, overnight stay in the hospital, and follow-up visits.


Please contact us with any questions that you may have.

 Related links:

Costs associated with weight loss surgery
Successful gastric bypass stories