Roux n Y Gastric Bypass

The Roux en Y Gastric Bypass operation entails making a small stomach pouch using a cutting stapler.  From the end of the “excluded stomach”, we follow the small bowel for a short distance and cut the bowel in two here (using a cutting stapler again). 

Then we bring the “downstream” side of the small bowel up to the small gastric pouch and use another type of stapler to connect the small gastric pouch to the “downstream” small bowel.  This “downstream” portion of the bowel now connected to the gastric pouch is called the “Roux limb.”

Then we measure 150 centimeters (about 60 inches) down the Roux limb and connect the portion of the bowel still attached to the excluded portion of the stomach to the Roux limb at this point.

So, this operation has two components.  A small pouch to restrict the amount of food taken in and an malabsorptive component.  The food doesn’t bypass much of the bowel (just the large part of the stomach and the very first part of the small bowel).  The very first part of the small bowel is where the digestive enzymes enter the bowel.  So, the digestive enzymes don’t mix with the food until about 60 inches down the small bowel (resulting in malabsorbption of complex foods)

Laparoscopic Adjustable Gastric Band

A silastic belt is guided around the top of the stomach.  The buckle is secured creating a small gastric pouch.  A catheter leads from the band to a port placed on the  abdominal wall muscles (under the skin).  The port can be accessed (using a syringe and a needle) allowing  adjustment of an inflatable bladder on the inside of the silastic belt (this effectively makes the passage from the small gastric pouch to the large portion of the stomach smaller).

The band makes a small amount of food satisfying, allowing weight loss.