Laparoscopic roux en Y gastric bypass

The “roux en Y” is often called the “gold standard” bariatric operation as it has been around for a long time and proven to be reliable. By changing the way food passes through the gut, around a metre and a half of small bowel (and the majority of stomach) is “bypassed”. This means that less calories are able to be absorbed after eating a certain meal.

A small stomach pouch is created offering some degree of restriction. Next, A piece of small bowel is joined to the stomach pouch with a further join further down. As a result of this reconfiguration, around a metre of bowel has no contact with food and another metre contacts food, but without digestive juices to aid absorption.

This procedure is most often done with keyhole, though there are times when an open procedure is necessary. It is not suitable for people who smoke or who take medical type of steroids and lifelong multivitamins are essential.

Residual stomach capacity: 30-50mls
Estimated weight loss: 60-70% EWL over 2 years.

Advantages

  • Traditional operation with well proven results of weight loss

  • Creates a low pressure system in the stomach pouch relieving reflux

  • Very reliable loss of weight

Disadvantages

  • Nutritional/ mineral supplements definitely required

  • “Dumping syndrome” is somewhat common (though encourages avoidance of sweets and chocolates)

  • Internal hernias occur in a few people needing urgent surgery (not suitable for people living far from healthcare)

  • Diarrhoea and or protein malnutrition can occur

  • A few people suffer stricture or bleeding at the join

  • Minor late weight regain 10-20% after 2-5 years