The UM Center for Weight Management & Wellness

Surgical Weight Loss

Laparoscopic Roux-en-Y Gastric Bypass Surgery

What is obesity?

Center director Mark Kligman, M.D., performs the minimally invasive Roux-en-Y procedure.

Obesity specifically refers to having an excess amount of body fat. A person is considered obese if he or she has a body mass index (BMI) of 30 or greater. Morbid obesity is typically defined as being 100 pounds or more over ideal body weight or having a BMI of 40 or higher. Calculate your BMI here.

According to the National Institute of Diabetes and Digestive and Kidney Diseases of the National Institutes of Health, approximately 280,000 adult deaths in the United States each year are related to obesity. Several serious medical conditions have been linked to obesity, including Type 2 diabetes, heart disease, high blood pressure, and stroke, and certain types of cancer.

What causes obesity?

In most cases, obesity results from genetic, environmental and psychological factors. Some illnesses can also lead to weight gain or obesity, including endocrine disorders (such as hypothyroidism and Cushing’s Syndrome), psychological disorders, and neurological problems. In addition, certain drugs, such as steroids and some antidepressants, can lead to either weight gain or increased appetite.

For More Information

Gastric Bypass Surgery Podcast

How is it treated?

Treatment may include a combination of diet, exercise, behavior modification, and weight-loss drugs. In some cases, weight loss surgery may be recommended.

What is the most common weight loss surgery performed in the U.S.?

According to the American Society for Bariatric Surgery and the National Institutes of Health, Roux-en-Y gastric bypass is the most frequently performed weight loss surgery in the United States and is the gold standard procedure for weight loss surgery.

What are the advantages of the Roux-en-Y gastric bypass?

Roux-en-Y offers the best balance between weight loss and risk of complications.

University of Maryland bariatric surgeon Mark Kligman, M.D., has a very impressive success rate with this procedure. On average, weight loss can average 80 percent of excess body weight one year after surgery.

Other advantages:

The average excess weight loss after the Roux-en-Y procedure is generally higher in a compliant patient than with restrictive procedures.
Studies show that after 10 to 14 years, patients on average have only gained back 10 to 13 percent of the lost weight.
A 2000 study of 500 patients showed that 96 percent of some associated health conditions studied (back pain, sleep apnea, high blood pressure, diabetes and depression) were improved or resolved.

How is the Roux-en-Y gastric bypass performed?

In Roux-en-Y, the stomach is divided, and a small pouch, which limits calories that can be taken in on a daily basis to less than 1,000, is formed as simultaneously the majority of the stomach is sealed off. A portion of the small intestine is then divided and sewn to the newly created small stomach pouch. This process limits the body’s ability to absorb calories. This procedure can be performed as a standard open surgery, or as a laparoscopic surgery.

How is a laparoscopic procedure performed?

Laparoscopic (minimally invasive) surgery involves several very small incisions rather than open surgery, which uses one large incision. Once the patient, who has been given general anesthesia, is asleep, a harmless gas is introduced into the abdomen to move the organs so that the surgeon can work in increased space and can see more when a tiny camera (a laparoscope) is inserted into one incision through a narrow hollow tube (a trocar).

This technique allows the surgeon to view images of the surgery site on a video screen. Then through other trocars inserted into the remaining small incisions, the surgeons introduce and manipulate long narrow surgical instruments that allow performance of the same procedures that take place in traditional open surgeries.

What are the advantages of the laparoscopic approach?

At the University of Maryland Medical Center, we only use the laparoscopic approach for Roux-en-Y because of the many advantages, including quicker recovery and shorter hospital stays, as well as a significantly reduced risk of wound infection. Patients also report less pain and quicker return to normal activity.

Who is a good candidate for this procedure?

Someone approximately 75 pounds overweight with a major obesity-related health problem (like type 2 diabetes, heart disease or sleep apnea) or someone greater than 100 pounds overweight without any other complications may be a good candidate for this type of surgery.

Why come to the University of Maryland Medical Center?

Dr. Mark Kligman, Director of the Center for Weight Management and Wellness at the University of Maryland Medical Center, is an expert in minimally invasive gastric bypass surgery. In the past five years, he has performed more than 400 laparoscopic Roux-en-Y operations with an outstanding rate of success and an extremely low complication rate.

At the University of Maryland Center for Weight Management & Wellness, patients benefit from our multidisciplinary approach to weight loss. We are strong believers that the surgery is just the beginning of the process, and that lifestyle changes are really required for long term successful weight maintenance. Our experts are committed to ensuring that patients receive the tools they need to achieve and maintain weight loss.

This page was last updated on: March 12, 2009.

If you would like to make an appointment or talk to someone about our services, please call 1-877-866-7348 (patients) or 1-800-373-4111 or 410-328-8940 (physicians).