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Laparoscopic Gastric Bypass, Roux en-Y

 


Gastric Bypass, Roux en-Y has been said to be the "gold standard"
operation for the treatment of Morbid Obesity


It is, in the opinion of some professionals, the procedure with the best combination of benefits and risks, for most patients. The operation is complex and difficult, whether performed by an open incision, or by laparoscopy.  It can be organised into three steps:

  • Division or partitioning of the stomach into two parts - an upper small pouch, and a lower, large pouch.
  • Creation of a Y-connection in the small bowel, to make a new end to connect to the stomach.
  • Connection of the new small bowel end to the upper stomach pouch, to bypass the stomach.
     

 

 

 


The results of this operation, show:
Operating time is slightly longer than the open operation (about 120-240 minutes laparoscopically, versus 120 - 180 minutes open).

Recovery time is shorter: typically 2-3 days in the hospital, and 8-10 days to return to full activity. Weight loss is excellent, averaging 80% of excess body weight after one year, and maintained at 80% for five years following surgery. Over 95% of all weight-related health problems (co-morbidities), such as high blood pressure, diabetes, sleep apnea, gastroesophageal reflux, stress incontinence, and degenerative arthritis pain, are relieved after 6 months after the operation - often much sooner.

Mortality rate has been less than 0.3%.

Complication rate has been similar to that with the open operation, except that no incisional hernias (hernias occurring through the scar of the incision) have occurred, with the laparoscopic technique. Surgeons emphasise that one should not think of the laparoscopic operation as reducing the risks of bariatric surgery. It reduces pain and discomfort, inconvenience, recovery time, and scarring.

Cosmetic results have been an added benefit for some younger patients, who now are proud to wear a two-piece bathing suit.

Laparoscopic Gastric Bypass can be performed on all but the very severely obese. We advise against attempting the technique when patients have had prior open operations in the upper abdomen, especially on the stomach.

 


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