What is a Roux-en-Y gastric bypass?
A Roux-en-Y gastric bypass is a weight loss operation that changes both how much you can eat and how your body handles food. The surgeon makes a small pouch at the top of the stomach and connects it directly to a loop of small intestine further down. Food then skips the rest of the stomach and the first stretch of small intestine, usually around 150 to 200 cm.
The name comes from the shape of the new plumbing: the intestine is divided and rejoined so that its two limbs form a letter Y. Unlike a gastric sleeve, nothing is removed. The larger part of the stomach stays where it is and keeps producing digestive juices, which drain into the intestine lower down.
A bypass works in several ways at once. The small pouch fills quickly, fewer calories are absorbed, and changes in gut hormones reduce hunger and help the body control blood sugar. This is why type 2 diabetes often improves within weeks, before much weight has been lost.
Who is a gastric bypass suitable for?
A bypass is considered when diet, exercise and medication have not led to lasting weight loss and your weight is harming your health. Our bariatric team usually assesses patients who:
have a BMI of 40 or more, or a BMI from 30 with a weight-related condition
live with severe acid reflux, type 2 diabetes, high blood pressure, high cholesterol or sleep apnea
have troublesome acid reflux or a hiatus hernia, where a sleeve could make symptoms worse
are ready to take supplements and attend follow-up for life
If you have a long-term condition such as thyroid disease, Crohn's disease or diabetes, you may need extra tests or a letter from your own doctor. Surgery is postponed if you have an active infection, and stomach polyps need to be dealt with first.
How the operation is done
The operation is carried out by keyhole (laparoscopic) surgery under general anaesthesia and usually takes 2 to 3 hours.
Tests and consultations
You have blood tests, an abdominal ultrasound, a chest X-ray, an ECG, a breathing test and an endoscopy of the stomach. You also meet the surgeon, the anaesthetist and an internal medicine specialist. You will be asked not to eat or drink for about 12 hours beforehand.
Keyhole access
The surgeon makes 4 to 6 small cuts in the abdomen and passes in a camera, which shows the inside of your abdomen on a screen, together with slim instruments.
Making the pouch
A stapling device separates a small pouch from the top of the stomach. At first it holds only about 30 ml. The rest of the stomach is sealed off but left in place.
Forming the Y
The small intestine is divided. Its lower end, called the Roux limb, is brought up and joined to the pouch. The upper end, which carries digestive juices from the bypassed stomach, liver and pancreas, is reconnected further down the Roux limb.
Leak test and closure
The new joins are checked for leaks, often with dye or an endoscope, and the small incisions are closed with dissolving stitches.
Recovery timeline
- First 24 hours
You are helped out of bed and encouraged to walk within a few hours. Compression stockings, blood-thinning injections and pain relief keep you safe and comfortable.
- Days 2–5
Once the team is satisfied, you start sips of water and then clear liquids. You move to the hotel after 4 nights in hospital.
- Weeks 1–3
You stay on liquids such as protein shakes, thin soups and herbal tea. Feeling tired is normal. If your job is not physical, you can usually return to work around two weeks after getting home.
- Weeks 4–6
Puréed and blended foods are added. Keep walking every day but do not lift more than 5 kg during the first month, and avoid strenuous activity and sex for the first four weeks.
- Months 2–24
You move on to soft and then normal textures in small portions, and regular exercise can begin. Avoid lifting more than 10 kg until three months. Weight loss is fastest in the first year and usually settles by 18 to 24 months.
Eating after a gastric bypass
A dietitian's plan guides each stage. In the long term you will need to:
eat slowly, chew well and stop at the first sign of fullness
keep food and drinks apart, leaving about 30 minutes between them
put protein first and keep sugar and fatty food low to avoid dumping syndrome
avoid fizzy and caffeinated drinks for at least two months (decaffeinated coffee is usually fine after about 10 days)
avoid alcohol, smoking and recreational drugs during recovery, and keep alcohol low afterwards, as it is absorbed much faster
take bariatric vitamins and minerals, including iron, calcium, B12 and vitamin D, for life
Risks and side effects
A gastric bypass is major surgery, and because it involves more of the digestive system than a sleeve, the overall complication rate is somewhat higher. Your surgeon will go through the risks with you before you sign the consent form.
Early risks
bleeding or infection
leakage from a staple line or join
blood clots in the legs or lungs
bowel obstruction
reactions to anaesthesia
These usually show up, if at all, within the first month. Early walking, compression stockings and blood thinners all lower the risk of clots.
Longer-term risks
vitamin and mineral deficiencies, which can cause tiredness, hair thinning, dry skin or anaemia if supplements are missed
dumping syndrome after sugary or rich food
low blood sugar a few hours after eating
gallstones during rapid weight loss
internal hernia, or ulcers at the join, especially in smokers or with anti-inflammatory painkillers
loose skin after major weight loss
Examining the bypassed stomach with an endoscope also becomes more difficult, though it is still possible with specialist techniques.
Results
Most patients lose around 60 to 80% of their excess weight over 12 to 24 months. Many also see improvements in type 2 diabetes, blood pressure, cholesterol, sleep apnoea, reflux and joint pain, and some can reduce their medication under their doctor's supervision.
The operation is a powerful tool, not a cure. Grazing, large portions and fizzy drinks can gradually stretch the pouch and lead to weight regain. If that happens, revision options include making the pouch smaller or narrowing the join, although there are fewer choices than after a sleeve.
Gastric bypass in Turkey: your trip
Before you fly
You send your height, weight, medical history and any recent results. Once the surgeon has reviewed them, you receive a treatment plan and a liver-reducing diet to follow before travel. Stop smoking at least a week before surgery and avoid alcohol in the run-up. Contraception or HRT containing oestrogen or progesterone is usually stopped about four weeks before; check with your doctor and use a non-hormonal method in the meantime.
In Istanbul
A VIP driver meets you at the airport and takes you to the hotel and hospital. A translator is with you through tests, consultations and discharge, a companion can stay with you at no extra cost, and meals, tests and medication are included in the package.
Back home
Your coordinator is available 24/7 on WhatsApp, follows you through each food stage and passes questions to the surgical team. The stitches dissolve on their own; if any remain after a few weeks, your GP practice can remove them.
What the Roux En Y Gastric Bypass package includes
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Hospital and medical care
Your private hospital room, nursing care, pre-operative tests, consultations with your surgeon, anaesthesia, the operation itself and the medication you take home.
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VIP transfers
A private driver meets you at the airport and takes you between the airport, your hotel and the hospital.
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Translator and companion
A medical translator at the hospital, and a companion can travel with you at no extra cost.
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Meals and comfort
Daily meals for you and your companion throughout your stay.
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24/7 patient coordinator
A dedicated coordinator answers your questions before, during and after your trip, in your language.
Your surgeons for Roux En Y Gastric Bypass
Roux En Y Gastric Bypass FAQ
How is a gastric bypass different from a gastric sleeve?
A sleeve removes most of the stomach but leaves the route of food unchanged. A bypass keeps the whole stomach inside you but diverts food past most of it and past the first part of the small intestine, so it reduces both portion size and calorie absorption. A bypass is often preferred if you have reflux or type 2 diabetes.
How much weight can I expect to lose?
Most patients lose around 60–80% of their excess weight over the first 12 to 24 months. The exact result depends on your starting weight, your eating habits and how active you are. Your surgeon will talk you through a realistic goal before surgery.
Am I eligible for a gastric bypass?
Our bariatric team usually considers a BMI of 35 or more, or a BMI from 30 with a weight-related condition such as type 2 diabetes, high blood pressure or sleep apnoea. Long-term illnesses may need extra tests or a letter from your doctor. The final decision is made after the team has reviewed your medical history.
How long do I need to stay in Turkey?
Plan for 5 days in Istanbul. You spend 4 nights in hospital and the last day at the hotel, with a final check before you fly home.
What is dumping syndrome?
It happens when sugary or rich food passes into the small intestine too quickly. You may feel sweaty, dizzy, sick or crampy, sometimes with diarrhoea. It is usually avoided by eating small protein-based meals, keeping sugar low and not drinking with meals.
Will I need to take vitamins for life?
Yes. Because part of the intestine is bypassed, your body absorbs less iron, calcium, vitamin B12 and vitamin D. Daily bariatric supplements and regular blood tests with your GP help prevent deficiencies.
Can a gastric bypass be reversed?
No part of the stomach is removed, so reversal is technically possible, but it is a complex operation and is rarely done. If weight regain becomes a problem, revision surgery to reduce the pouch or narrow the join is more common.
When can I return to work and exercise?
If your job is not physical, most people return to work about two weeks after getting home. Walking starts on the day of surgery, and regular exercise can usually begin from about two months. Avoid lifting more than 5 kg in the first month and more than 10 kg in the first three months.
