The most common operative procedure we perform at Duke Weight Loss Surgery Center is the Roux-en-Y gastric bypass.

It results in weight loss mostly by reducing the size of your stomach, so you cannot eat as much, and partly by bypassing some of your small intestines so you absorb less fatty foods and have less tolerance for sweets.

This is currently considered to be the “gold standard” weight loss surgical procedure. It is accepted by obesity surgeons and the major obesity physician societies as being the most effective in weight reduction and maintenance of weight loss.

For your insurance company, the code for this operative procedure is: CPT 43644 and the ICD-9 code for the diagnosis of morbid obesity is 278.01

Laparoscopic Versus Open Surgery

We prefer performing the surgery using laparoscopic techniques, avoiding a large incision in your abdomen. However, an abdominal incision is sometimes necessary based on your weight, body shape, and previous surgery.

The decision to proceed with laparoscopy versus open surgery will be made during your clinic visit.

The surgical procedure remains the same regardless if done with the laparoscope or as an open procedure.

A small stomach pouch (about the size of a medium egg) is created with a stapler device. The small intestines are then divided and one end brought up and connected to the small stomach pouch using the stapler. The intestines are then reconnected as shown.

Gallbladder Removal

Several studies have shown that people who experience significant weight loss can develop gallstones. Because of this possible complication, some surgeons choose to remove the gall bladder during gastric bypass.

Often, however, people who develop gallstones do not suffer any consequences or even know they have them.

Removal of the gallbladder at the time of a Roux-en-Y gastric bypass is somewhat difficult, due to the required location of the trocar sites to perform the weight reduction surgery.

In many cases the risk of taking the gallbladder out at the same time may well exceed any potential benefit. For this reason, unless you currently have gallstones that are causing trouble, we do not routinely remove the gallbladder at the time of your weight loss surgery operation.

If you are known to have gallstones, we will discuss the possible risks for removing it with you and use our best judgment with respect to its removal at the time of surgery.

Complications and Expected Weight Loss

See a table that shows the incidence of complications we have monitored following surgery at Duke.

Patients who undergo gastric bypass surgery lose between 100 and 180 pounds. Most of the weight is lost during the first 14 months, although some additional weight can be lost up for up to two years.

Get more details about expected weight loss.

Locations

This service is available at:

• Duke Center for Metabolic and Weight Loss Surgery
  Health Services Center, 407 Crutchfield Street, Durham, NC 27704
• Durham Regional Hospital
  3643 Roxboro Road, Durham, NC 27704