Roux-en-Y Gastric Bypass

Roux-en-Y gastric bypass (pronounced roo-en-why, or simply RYGB) involves both restrictive and malabsorptive techniques to produce long term weight loss. Restrictive (due to the creation of a small stomach pouch), and malabsorptive (due to bypassing a major portion of the small intestine). RYGB is considered the "gold standard" of weight loss surgery in the United States.  RYGB provides excellent long-term weight reduction along with the resolution or elimination of co-morbidities (i.e., medical conditions that exist in addition to obesity).

RYGB can be performed as a laparoscopic (minimally invasive) procedure which involves the use of a small telescope-like camera and small incisions made in the abdomen, or as an open procedure.  The term "open" is generic, as it does not specifiy the length of the incision.  Our midline incision is much smaller than most, allowing for a recovery that is very much comparable to the laparoscopic approach.   This is, therefore,  different from the usual "open" gastric bypass described by most other surgeons. 

General Procedure

First, the stomach is reduced in size by using surgical staplers, dividing the top-most part of ther stomach. This new smaller stomach (or pouch) is only able to hold a few ounces of food at one time. Next, the small intestine is divided, and a Y-shaped anatomy of the small intestine is created.  One limb of the "Y" (the alimentary limb, aka Roux limb) is attached to the pouch allowing food to bypass the upper intestine. Bypassing the larger part of the stomach allows for less food portions.  Bypassing two segments of the small intestine, known as the duodenum and the uppermost jejunum, allows the body to reduce the amount of calories and nutrients the body absorbs.

Because RYGB is so restrictive in nature, patients are compelled to make a lifelong commitment to changing their diet. The size of the new stomach pouch will no longer allow the same eating habits to exist since the pouch has the capacity to hold only a few ounces of food at one time. Making good food choices is a critical component to achieving success with RYGB. An adequate amount of protein as well as a strict implementation of vitamin supplements is necessary due to the malabsorptive aspect of RYGB.  Our program is very detailed and will prepare you very well for this major healthy lifestyle change. 

Advantages of Roux-en-Y Gastric Bypass (RYGB):

  • Excellent weight loss (75% of the excess weight in 1-2 years)
  • Overall improved health.
  • Resolution or elimination of co-morbidities (e.g., type II diabetes, sleep apnea, hypertension and more).

Disadvantages of Roux-en-Y Gastric Bypass (RYGB): (this is not a comprehensive list of the complications of surgery)

  • Disruption of the staple line can lead to leakage or serious infection (rare, less than 1%).
  • Possible malnutrition or anemia.
  • Possible obstruction of the GI tract.
  • Dumping syndrome. (or is it an advantage ?)
  • Various other post surgical complications.