The laparoscopic gastric bypass with Roux-en-Y gastrojejunostomy consists of separating the stomach into two sections using parallel rows of titanium staples. The staples remain in place. The small upper segment connected to the esophagus remains the functional portion of the stomach, while the larger lower segment connected to the duodenum becomes the non-functioning portion of the stomach.
In the next phase of the surgery, the surgeon separates most of the small intestine from the stomach and brings one end up to the small upper segment of the stomach which is still connected with the esophagus. This section of the intestine is still functional. When the intestine is connected to this small stomach pouch, the opening is about the size of a dime. This allows food to slowly pass directly into the intestine, where it is digested.
Next, the small intestine is then reconnected in the shape of a “Y.” This connection is about 40 inches below the first. Digestive juices form in the lower, now non-functional, segment of the stomach and the duodenum and empty into the small intestine at the “Y.” Thus, food that enters the small upper stomach pouch will mix with secretions from the lower stomach pouch and duodenum. Digestion and absorption of food nutrients are carried on in a completely normal way from that point.
The procedure results in dramatic weight loss and improvement or resolution of conditions associated with obesity such as type II diabetes, high blood cholesterol, high blood pressure, obstructive sleep apnea and gastro-esophageal reflux disease.
The procedure alters the digestive process which can lead to malabsorption of nutrients. Also, if a larger meal or high sugar food is consumed dumping syndrome can occur. While unpleasant, the dumping syndrome helps patients learn healthy eating habits.
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