Roux-en-Y Gastric Bypass Surgery
According to the American Society for Metabolic and Bariatric Surgery and the National Institutes of Health, Roux-en-Y gastric bypass is the current gold standard procedure for weight loss surgery. In the U.S., over 200,000 gastric bypass procedures will be performed in 2011, far outnumbering the adjustable gastric band, sleeve gastrectomy and other weight loss procedures. To date we have performed over 2,500 gastric bypass procedures at MUSC.
Roux-en-Y gastric bypass (RGB), is both restrictive and malabsorbtive. The stomach is stapled and divided to create a small pouch (about the size of a golf ball) that dramatically restricts portion size and gives the feeling of fullness after just a few bites of food. A limb of small intestine, 150 cms long (the “Roux limb”) is then connected to the stomach pouch so food can travel down the intestine where it meets with the “biliary limb” which drains the lower (excluded) stomach, the duodenum and upper small intestine. This limb carries digestive juices. Where these 2 limbs meet, digestion begins. This is the malabsorbtive part of the gastric bypass operation and because the upper part of the intestine is bypassed by food, less calories are absorbed.
The Roux-en-Y gastric bypass surgery is usually performed laparoscopically. This means that small incisions are used to insert small thin plastic tubes into the abdomen. A video camera with a long lens is passed through one of these tubes and long instruments and staplers are passed through the rest. The surgeons perform the surgery while looking at images from the camera inside the abdomen projected onto high definition monitors at the head of the OR table. We try to perform laparoscopic surgery on all patients nowadays. We have no weight limit and have completed gastric bypass on patients with very high BMI. Occasionally it is necessary to perform the surgery through an open incision. Usually this is because of previous operations which make the laparoscopic approach impossible. The laparoscopic approach to gastric bypass reduces the amount of post operative pain the length of hospital stay, the amount of scarring, and results in quicker recovery compared to an open procedure.
- More information on the Roux-en-Y bypass procedure
- Risks of Gastric Bypass procedure
- Approaches to Surgery: Open verses minimally invasive surgery
Roux-En-Y Gastric Bypass Surgery Animation
Animation courtesy of Ethicon Endo Surgery- a Johnson & Johnson Company