Roux-en-Y Gastric Bypass

The Roux-en-Y gastric bypass is the most popular form of weight loss surgery in the US. This procedure can be performed laparoscopically or with an open incision, but once the surgeon gains access to the abdominal cavity, the internal procedure is the same. The Roux-en-Y is a two-part surgery in which the surgeon restricts the amount of food the stomach can hold and bypasses a portion of the small intestine so that it can absorb fewer nutrients and calories.

During the first part of the Roux-en-Y gastric bypass procedure, the surgeon uses surgical staples to divide the stomach into two parts-a tiny pouch that will serve as the new stomach and a larger portion that will not come in contact with the food but that will stay intact and produce digestive juices. During the second part of the Roux-en-Y procedure, the upper portion of the small intestine is divided in half. One half is used to form a new outlet for the tiny new stomach pouch. The other end of the divided intestine is then reconnected downstream from the division, forming the "Y" described in the name of this weight loss surgery procedure. 

By rerouting the gastro-intestinal anatomy in this way, food bypasses most of the stomach and the upper portion of the small intestine that contains most of the digestive enzymes. The combined effect of the smaller stomach capacity and intestinal malabsorption greatly reduces the calories and nutrients entering the blood stream.

The food and the digestive enzymes from the bypassed portion of the stomach and small intestine come together at the "Y" connection and pass through the remaining portion of the small intestine together. This allows sufficient time for the body to absorb enough nutrients to meet its needs.

Laparoscopic or Open Roux-en-Y Procedures

If performed laparoscopically, a surgeon will insert a miniaturized video camera and specialized surgical tools into your abdomen through a series of small incisions. You will require on average a two-day hospital stay and ten days to six weeks for recovery, depending on the physical requirements of your job. When you have this surgery performed laparoscopically, you reduce your risk of wound infection, healing difficulties, and an incisional hernia.

If yours is an open procedure, the surgeon will make a 6-8 inch incision in your abdomen, beginning just below your breast bone and ending at your naval. Once the abdominal cavity is open, the rest of the surgery, except for wound closing, proceeds as described above. With an open Roux-en-Y procedure, you will require, on average, a three-day hospital stay and three to six weeks of recovery time, depending on the physical requirements of your job. You will be at increased risk for wound healing problems, although these can be minimized by closely following all post -operative care instructions.

Your surgeon will determine which approach is best for you based on your health, weight, and history of previous abdominal surgeries.