Roux en-Y Gastric Bypass is considered to be the “gold standard” of all bariatric surgical procedures because the gastric bypass is a time-tested operation (dating back to the late 1960′s). Significantly more information is available about the long-term results of the Roux en-Y Gastric Bypass (as compared to other available procedures) because its results have been documented for over 20 years.
During normal digestion, food moves down into the stomach from the esophagus. While in the stomach, the food is broken down by gastric juices. This process takes about twenty to thirty minutes, after which the stomach contents move to the first segment of small intestine. Most of the iron and calcium in the foods we eat is absorbed at this time. The remaining segments of the small intestine complete the absorption of almost all calories and nutrients. The remaining food particles that cannot be digested in the small intestines are stored in the large intestine until eliminated.
The Roux en-Y operation provides a restrictive and malabsorptive method to weight loss because the stomach and small intestines are reconfigured. First, a “mini stomach” is created by permanently dividing the stomach, creating a stomach pouch that can hold about 2-3 bites of food. The intestine is then cut approximately one and one half feet beyond the stomach and is attached to the pouch to provide an outlet for the food. This aids in weight loss in that you cannot eat as much and you absorb fewer nutrients and calories.
Instead of food staying in the stomach for the “normal” twenty to thirty minutes, it now stays in the “mini pouch” for about ten minutes, then moves on to the small intestine. The pouch maintains a sensation of fullness for a longer period of time.
Digestive juices are still produced in the lower part of the stomach and are released into the intestines where they help the food digest. Nutrients and calories can still be absorbed, but the food is not as thoroughly digested so a greater portion moves into the large intestine to be released.
The Roux en-Y Gastric Bypass Surgery may be performed “open” or “laparoscopically”. When performed as an “open” procedure, a midline incision on the abdomen is made extending from just under the diaphragm to a spot close to the belly button. A stapling device is used to create the “mini pouch”.
The “laparoscopic” approach, also known as “minimally invasive surgery” follows the same guidelines internally, however this surgery is done using 5-6 small keyhole incisions. A camera is inserted into one of the incisions, to aid the surgeon for guidance. Several small instruments are inserted into the other incisions to perform the surgery.
The Roux en-Y Gastric Bypass procedure is not right for everyone. Here are some of the things we will consider when evaluating your candidacy for obesity surgery.
The Roux en-Y Gastric Bypass procedure may be right for you if:
Your BMI is 40 or higher or you weigh at least twice your ideal weight or you weigh at least 100 pounds more than your ideal weight. (BMI is calculated by dividing body weight (lbs.) by height in inches squared (in2) and multiplying that amount by 704.5).
If you do not meet the BMI or weight criteria, you still may be considered for surgery if your BMI is between 35 – 40 and you are suffering from 2 or more of the following co-morbidities:
-Diabetes Mellitus (Adult Onset)
-Osteoarthritis of knees, hips, and/ spine (lumbar region)
-Cardiomegaly related to Obesity
-Polycystic Ovarian Syndrome
-Has documented failure at medically supervised weight reduction programs for at least 6 months
-Demonstrates motivation and commitment for long-term lifestyle changes related to weight loss, diet, and exercise
-Obesity is not caused by other disease or medications
-No cigarette smoking for at lease 3 months