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Roux-en-Y Gastric Bypass

The Roux en-Y Gastric Bypass has long been considered the “gold standard” for obesity surgery; all other procedures are compared to this when establishing their effectiveness. It is primarily a “restrictive” procedure with some, minimal, malabsorption of digested food.

This operation accomplishes weight loss through satiety (fullness), achieved by creating a one to two ounce pouch out of the old stomach. The small intestine is divided some 70 to 90 cm downstream from the stomach, and is reconnected to the stomach with a double-stapled anastomosis, which is buttressed with additional sutures. The other end of the bowel is reconnected to itself at a point approximately 75 cm downstream via a stapled connection. Food flows from point-to-point, where it mixes with digestive enzymes from the stomach, small bowel, liver, and pancreas. These enzymes then work to break down food for digestion. The real key to weight loss is in the radically-reduced volumes of food that can be eaten at any one meal. All of this is accomplished with very rare, if ever, sensations of hunger during the first 6 to 12 months after surgery.

The result is a very early sense of fullness, followed by a very profound sense of appetite satisfaction, with the most minimal meal volumes. Most patients are full on one to two ounce meal portions originally. After six months, they are satisfied with three to five ounce servings— still quite small. Even though the portion size may be small, there is rarely hunger, and no feeling of having been deprived. When truly satisfied, you feel indifferent to even the choicest of foods. Patients continue to enjoy eating – but they enjoy eating less volume.

The Gastric Bypass provides an excellent tool for gaining long-term control of weight. Now, without the hunger or craving usually associated with small portions or with dieting, it is entirely normal for patients to lose 75-100% of their excess weight… often as early as the first anniversary after surgery. Long-term success is dependent on accepting new rules for eating and food selection that will be taught in the pre-operative and follow-up periods, before and after surgery. Your new-found energy levels and activity interests will lead to increased planned exercise and a more active lifestyle.

We perform this procedure as a minimally-invasive (laparoscopic) procedure—small incisions to allow access to the abdominal cavity though inserted tubes. On very rare occasions, a planned laparoscopic procedure will have to be converted to an “open” procedure, for safety reasons. Both approaches have similar risks and complications; both have excellent long-term success potential. We have performed over 1500 such procedures and our conversion to open rate in our last 500 cases is far less than 1/2%!