Obesity Surgical Options - Roux-en-Y gastric bypass (RYGB)
The Roux-en-Y gastric bypass operation is truly a by-pass of the stomach. The stomach is by-passed so that food eaten goes into a small gastric pouch and then into a loop of small bowel (the jejunum).This procedure is usually performed laparoscopically (i.e. keyhole surgery with a telescope); however, in some cases, it may be necessary to perform an open procedure through a large cut in the abdomen, usually if you have had an open operation before.
Roux-en Y Gastric by-pass (RGB) is the current “gold standard” weight control operation. It is the operation to which all other procedures are compared.
In the gastric bypass operation, the top part of the stomach is stapled off to create a small gastric pouch with a volume of about 15mls. The jejunum is divided and the cut end of the jejunum is attached to the small stomach pouch. The other small bowel end is joined back to the small bowel about a metre down from the stomach. With this re-routing, the remainder of the stomach and the top end of the small intestine (duodenum) are bypassed.
This type of bypass operation has proven to be an effective, consistent way of losing weight and keeping it off, but to achieve these results it requires lifelong changes to lifestyle and eating.
This procedure has a higher complication rate than some of the other operations (i.e. gastric banding), however the weight loss is more consistent and patients can expect to lose more, quickly. The expected average weight loss has been reported to be about 60% of excess weight and will still be influenced long-term by exercise and diet. There are a large number of patients who regain weight after the second year, mainly because they return to the old lifestyle they had prior to surgery. Patients will need to take daily supplements for the rest of their life. The complications that arise from dividing and stapling include bleeding, leaks from joins or staple lines, and bowel obstruction.