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Roux-en-Y surgery in India

Overview

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The name Roux-en-Y is derived from the surgeon that first described it (Cesar Roux) and the stick-figure representation. Diagrammatically, the Roux-en-Y procedures looks like the letter Y; typically, the two upper limbs of the Y represent a proximal segment of small bowel and the distal small bowel it joins with (which is often a blind end), and the lower part of the Y the distal small bowel (beyond the anastomosis). Roux-en-Y’s are used in several operations and collectively called Roux surgery. Roux-en-Y is currently the most commonly performed bariatric operation in the United States, and roughly 7 out of 10 bariatric surgeons use it as their primary weight loss procedure.

What is Roux-en-Y Surgery?

Roux-en-Y (often abbreviated RNY and pronounced roo-en-why) is gastric bypass surgery known as the gold standard of weight loss surgeries - is a Gastric bypass procedure, which involves creating a stomach pouch out of a small portion of the stomach and attaching it directly to the small intestine, bypassing a large part of the stomach and duodenum. Not only is the stomach pouch too small to hold large amounts of food, but by skipping the duodenum, fat absorption is substantially reduced.

How does Roux-en-Y Surgery Work?

The Roux-en-Y Surgery procedure accomplishes two important tasks. First, it separates the stomach, creating a smaller pouch for food that gives patients a sense of "feeling full" after eating significantly smaller amounts of food. Second, a bypass of the upper portion of the small intestine reduces the ability to absorb calories and nutrients. This quality is known as a "malabsorptive" property. Roux-en-y bariatric surgery does not involve removal of the stomach. The stomach is still able to produce digestive juices. While the duodenum (the first section of the small intestines) is no longer attached to the stomach, this "bypassed" section is surgically connected further down the intestinal tract — at a "Y" intersection — to provide some of the benefits of normal food breakdown. The "proximal" approach, the method most commonly used, involves a higher attachment of the upper small intestine. In fewer cases, a "distal" roux-en-y involves reattachment of the small intestine further down intestinal tract. The further the duodenum is attached, the more like a patient will experience malabsorptive values, resulting in even less caloric processing (and less nutrient absorption). Another variation of the Roux-en-Y procedure involves creating a "Y" formation between the stomach pouch and the intestinal attachment.

Am I the Candidate for Roux-en-Y Surgery?

There are many criteria when determining if a patient is a suitable Candidate for Roux-en-Y Surgery.


How to Prepare for Roux-en-Y Surgery?

The way you prepare for Roux-en-Y Surgery sets the tone for the success of your operation and recovery. Patients who are not committed to their pre-operative duties may find that their doctors postpone or cancel the surgery itself. Roux-en-Y surgery makes it easier to lose weight but the patient still has to do a lot of hard work. Prepare diligently for pre-op to prove you are ready for the challenges of post-op. Try following the tips given below as for the preparation of your surgery:

What is the Procedure of Roux-en- Y Surgery?

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Roux-en-Y Surgery is performed as either an open or a laparoscopic procedure, a single-incision operation that typically takes less time to complete. Benefits of laparoscopy include a reduction in overall postoperative pain and a shorter recovery process. Both involve the same, or similar, techniques. During a Roux-en-Y Surgery, the surgeon creates a small stomach pouch (15-30 ml in volume) at the upper part of the stomach either by using surgical staples or a gastric band. The site for the small pouch is usually sited in a section of the stomach which is least likely to stretch. The stomach pouch is totally separated from the rest of the stomach and instead is connected directly to the middle portion of the small intestine (jejunum), bypassing the lower part of the stomach and the early segment of the small intestine (duodenum). The tube connecting the pouch to the jejunum is called the "roux limb" or "food channel". Meanwhile, gastric juices from the stomach and digestive enzymes from the pancreas, and bile, continue to flow from the lower part of the stomach and duodenum down the small intestine which is referred to as the "alimentary channel".

These two channels meet at a Y-shaped junction - which gives the procedure its name - and together form a common channel where absorption of nutrients and calories begins. There are two basic variants of the Roux-en-Y Surgery procedure: a proximal roux-en-Y, in which Y-intersection occurs at the upper or proximal part of the small intestine, and a distal roux-en-Y in which the Y-intersection is joined to the lower or distal part of the small intestine. The proximal roux variant allows for greater absorption of nutrients, while the distal variant provides less absorption of food - mainly of fats and starches, but also of various minerals and fat-soluble vitamins - but greater weight loss. In both cases, the roux-en-Y patient experiences a very rapid feeling of fullness in the stomach, followed by a feeling of growing satiety after starting to eat.

What is the Post Operative Care after Roux-en-Y Surgery?

This could be bifurcated into two ways, care to be taken during the hospital stay and at home.

At Hospital: While you are recovering at the hospital, you may receive the following care:

At Home: Be sure to follow your doctor's instructions. You will need to practice lifelong healthy eating and exercising habits. Keep in mind after your surgery:

You may need to take medicines, as directed by your doctor, which may include:


What is the Weight Loss after Roux-en-Y Surgery?

Typically the patients lose roughly 70 percent of their initial excess body weight during the first 24 months after Roux-en-Y Surgery. Occasionally, patients’ experiences a weight regain of about 10 percent between years 2 and 5. Bariatric experts attribute this to two factors. First, the functional capacity of the small pouch increases in volume to accommodate more food. Second, roux patients learn how to take in extra calories without incurring symptoms of dumping syndrome and making themselves sick. This second factor can only be corrected by greater patient compliance with post-op dietary guidelines brought about by greater post-op counseling and support services.


What are the Benefits of the Roux-en-Y Surgery?

The following are the benefits of Roux-en-Y Surgery:

What are the Risks of Roux-en-Y Surgery?

Dumping syndrome," the situation in which the body quickly expels food after eating, is a common side effect of following RNY. While RNY prevents the body from being able to process fats and sugars as it did before, it also causes the body to react adversely to eating too fast or too much at one time.


What are the Alternatives to Roux-en-Y Surgery?

The following are the recommended alternatives for Roux-en-Y Surgery

Mini-Gastric Bypass: uses the loop reconstruction, has been suggested as an alternative to the Roux en-Y procedure, due to the simplicity of its construction, which reduced the challenge of laparoscopic surgery. MGB combines two surgeries: Collis gastroplasty — lengthening of the esophagus by creating a tube from the upper part of the stomach — and Bill Roth II loop Gastrojejunostomies, which involves connecting the small intestine to the stomach. Essentially, a narrow, long pouch is formed and reconnected to the intestines about 6 feet from the stomach without actually severing the small intestines. No food is emptied into the larger, sectioned-off portion of the stomach or small intestine, thereby limiting calorie absorption.

Why Roux-en-Y Surgery in India?

Roux-en-Y Surgery in India is one of the most prominent obesity surgery procedures that are being undertaken by global patients coming from all across the world. The medical and healthcare amenities in India are excellent in terms of cost and quality. This surgery comes with the best medical care for weight loss benefit.

The medical infrastructure in India has state of the art Hospitals and the best qualified doctors and obesity surgeons. With the best infrastructure, high quality medical amenities, accompanied with the most competitive prices, the foreign patients are amazed by the hospitality and treatment for Roux-en-Y Surgery in India in India.

The hospitalization amenities at the obesity surgery hospitals in India have modern amenities equipped with state of art technologies for effective medical treatments at quiet affordable costs. These hospitals are available in the following Indian cities:

Mumbai
Hyderabad
Kerala
Delhi
Pune
Goa
Bangalore
Nagpur
Jaipur
Chennai
Gurgaon
Chandigarh

Besides, getting effective medical treatment one can also get a view of Indian cultural heritage by enjoying holiday vacations at the best Indian tourism resorts.

What is the Cost of Roux-en-Y Surgery in India?

Cost comes first to decide the Roux-en-Y Surgery in India, since it comes with high quality as witnessed in developed nations. The lower cost includes significantly longer post-operative care in the hospital itself. The costs are usually a lot lower than even the deductible most insurance company's levy on a patient. The following figure indicates the cost of certain treatments in US and India, which are makes the overseas patients to look abroad for their medical treatment in India.

Surgery

USA (in USD)

India (in USD)

Roux-en-Y Surgery

26,500

7,200

Gastric Banding Surgery

24,000

8,970

Intragastric Balloon Surgery  

24,809

4,860


Some of the common countries from which patients travel to India for surgery are:

USA
UK
Canada
Australia
Zealand
Nigeria
Kenya
Ethiopia
Uganda
Tanzania
Zambia
Congo
Lanka
Bangladesh
Pakistan
Afghanistan
Nepal
Uzbekhistan





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