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 2009, far outnumbering the adjustable gastric band, duodenal switch, and vertical banded gastroplasty procedures. Currently, we have performed over 1,900 gastric bypass surgery procedures at MUSC. Roux-en-Y gastric bypass (RGB), the most commonly performed bariatric procedure, is both malabsorptive and restrictive. This roux-en-Y gastric bypass can result in two-thirds of extra weight being lost within two years. The procedure involves stapling the stomach to create a small pouch that holds less food and then shaping a portion of the small intestine into a “Y”. The “Y” portion of intestine is then connected to the stomach pouch so that when food is being digested it travels directly into the lower part of the small intestine, bypassing the first part of the small intestine (called the jejunum) and the first part of the second section of the small intestine (called the duodenum). The effect of circumventing these organs with a roux-en-Y gastric bypass is to restrict the amount of calories and nutrients that are absorbed into the body. The Roux-en-Y gastric bypass surgery may be performed with a laparoscope rather than through an open incision in some patients. The Roux-en-Y gastric bypass uses several small incisions and three or more laparoscopes - small thin tubes with video cameras attached - to visualize the inside of the abdomen during the operation. The surgeon performs the gastric surgery while looking at a TV monitor. Persons with a Body Mass Index (BMI) of 60 or more or those who have already had some type of abdominal surgery are usually not considered for Roux-en-Y gastric bypass. A laparoscopic method allows the physician to make a series of much smaller incisions. Laparoscopic gastric bypass usually reduces the length of hospital stay, the amount of scarring, and results in quicker recovery with Roux-en-Y gastric bypass than an open procedure.  More information on the Roux-en-Y bypass procedure
Risks of Gastric Bypass procedure
Brief History and summary of Bariatric Surgery (ASMBS)
Approaches to Surgery: Open verses minimally invasive surgery
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