Roux-en Y Divided Gastric Bypass Surgery

(New York Weight Loss Doctors, Long Island Weight Loss Doctors)

Surgical operations for the control of clinically severe obesity are based on one or both of two principles. The first is restriction, whereby the amount of calories or food ingested is controlled by limiting space available. The second principle is malabsorption, whereby the absorption of food is controlled or reduced. To better understand how the gastric bypass weight-loss surgery works, it is helpful to know how the normal digestive process works.

As food moves along the digestive tract, special digestive juices and enzymes arrive at the right place at the right time to digest food and absorb calories and nutrients. After we chew and swallow our food, it moves down the esophagus to the stomach, where strong acid and powerful enzymes continue the digestive process. The stomach can hold about three pints of food at one time. Food is slowly released into the small intestine where absorption of the nutrients, vitamins and minerals takes place. The rate at which foods and fluids are released into the small intestines is controlled by a sphincter on the outlet of the stomach.

The divided gastric bypass with Roux-en-Y gastric Bypass consists of separating the stomach into two sections using parallel rows of titanium staples; the staples remain fixed and do not migrate. The small upper segment connected to the esophagus remains the food-functional portion of the stomach, while the large lower segment connected to the duodenum, though still functional, does not deal with food eaten by the patient.

In the next phase, the surgeon disconnects the continuity of the small intestine and brings the lower end up to the small gastric pouch still connected with the esophagus. This section of the intestine is still functional. The intestine is connected to this small stomach pouch by means of an opening about the size of a dime. This allows food to pass directly into the intestine where it is digested.

When the small functioning upper stomach pouch is full (at first this will occur with only a nibble or two), patients experience a sense of fullness. In this way, and because the appetite will also be reduced, the intake of food is dramatically limited. This is what enables weight loss. What food is eaten is handled by the body quite well.

On average, patients will lose about 100 lbs. or up to two thirds of their excess weight in one year. Some people lose a little more, some a little less. Weight loss will continue during the second year at a less rapid rate.

The advantages of Roux-en-Y gastric bypass include superior weight loss when compared to vertical banded gastroplasty, with excellent long-term weight reduction and resolution or elimination of co-morbidities (80 percent resolution of Type II diabetes after surgery). Early and late complication rates are reasonably low, and operative mortality ranges from 0.2 percent to 1 percent.

Disadvantages of Roux-en-Y gastric bypass include the potential for leaks and strictures, severe dumping syndrome symptoms and procedure-specific complications, including distension of the excluded stomach and internal hernias.

Watch these videos about the Roux-en-Y gastric bypass surgery below

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