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). RYGBis considered the “gold standard” of weight loss surgery and is the most commonly performed bypass surgery in the U.S. today. RYGB has become the weight loss surgery of choice for many patients due to its superior weight loss results with minimal, yet controllable, side effects. 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 inserted through a small incision made in the abdomen, or as an open procedure where a large midline incision is made in the abdomen. The laparoscopic method is the most commonly used today and is the method of choice for many surgeons. While this method has many advantages, like faster recovery periods, not everyone is a candidate for this type of surgery. You and your surgeon can decide which procedure is right for you.
First, the stomach is reduced in size by using surgical staples or the vertical banding method. This new smaller stomach (or pouch) is only able to hold a few ounces of food at one time. Next, a Y-shaped section of the small intestine is attached to the pouch allowing food to bypass the lower stomach. Bypassing the two segments of the small intestine, known as the duodenum and the 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. Patients also need to try and avoid sweets and fatty foods as much as possible.
Advantages of Roux-en-Y Gastric Bypass (RYGB):
- A reasonably low mortality rate (0.2% to 1%).
- Excellent weight loss when compared to Vertical Banded Gastroplasty (VBG).
- 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):
- Disruption of the staple line can lead to leakage or serious infection.
- Possible malnutrition or anemia.
- Possible obstruction of the GI tract.
- Risk of a hernia.
- Risk of chronic vomiting and diarrhea, or dumping syndrome.
- Various other post surgical complications.