Programs : Advanced MI & Robotic Surgery

Roux-en-Y Gastric Bypass (RYGB)
The Roux-en-Y (pronounced “roo-en-why”) gastric bypass is currently the most commonly performed weight loss operation in the United States. It has been around for over 30 years and has been demonstrated to provide an excellent balance of weight loss and manageable side effects. The operation can be performed either laparoscopically, through six very small incisions in the abdominal wall, or open, through a traditional midline abdominal incision.
In the Roux-en-Y gastric bypass procedure, a surgical stapler is used to separate the upper portion of the stomach from the lower portion. The upper portion is referred to as the “pouch.” This pouch is then connected to a limb of small intestine called the “Roux limb.” Food enters the pouch, and then passes through the alimentary limb. The bypassed limb (B-P, or biliopancreatic) contains digestive juices. Food finally mixes with the digestive juices in the “common channel,” the part of small intestine downstream from the Y connection.
The gastric bypass promotes weight loss by both restriction and malabsorption mechanisms:
• Restriction: The new stomach pouch is small and fills very quickly after eating only a small amount of food to provide a sensation of fullness. Thus, the pouch places a physical restriction on the amount of food you are able (or want) to eat at one sitting.
• Malabsorption: Because sections of the stomach and intestines are bypassed, you will absorb fewer nutrients from the food you eat. You will need vitamin and mineral supplements after the operation for the rest of your life.

Advantages
• Experience: RYGB has been around the longest of all three surgeries. There is
more follow-up data available for this procedure than for the others.
• Faster results: Weight loss is more rapid than the lap band if you follow dietary
guidelines.
• No foreign body: RYGB leaves no devices behind
• Follow up: Less postoperative visits are needed, no adjustments after the surgery.
• Many co-morbidities improve shortly after surgery, prior to any significant weight
loss.

Disadvantages
• Postoperative healing: Surgery is more extensive, with re-routing of digestive
organs. There is more pain and it takes longer to heal from this procedure than
from the LAP BAND®.
• Hospitalization: Usually two to three days in the hospital
• Permanent: This procedure is not reversible, although revisions are possible in
certain circumstances.