Laparoscopic Gastric Bypass (Roux en Y)
Roux-en-Y Gastric Bypass is "Gold Standard," for a Reason
The Roux-en-Y Gastric Bypass is the most common bariatric surgery and is widely accepted as a most effective surgical weight loss treatment. It remains the "gold standard" for bariatric surgery, said Dr. David Greenbaum, medical director of the bariatric surgery program at Lourdes Medical Center of Burlington County.
"All of the surgeries are appropriate in the right circumstances and there are advantages and disadvantages to each," he said. "The reason that Roux-en-Y has been the gold standard is that it is a relatively easy operation and the results are also quite good."
He said the procedure helps the patient lose weight in several ways. A drastically reduced stomach means the patient will eat much less but feel full. Because part of the small intestine is bypassed, there is a decrease in the amount of calories the body absorbs, which is the malabsorptive feature of the surgery.
And because the reconfigured digestive system will not easily tolerate foods high in sugars, patient appetites will change. Because high sugar foods cause a "dumping syndrome" creating intestinal distress, patients are inclined to avoid them, said the surgeon.
During the procedure the surgeon turns the stomach into a one-ounce pouch by stapling it away from the rest of the stomach. This restrictive action, reducing stomach capacity from two quarts to one ounce, allows the patient to feel full after eating only a small amount.
The bypass part of the procedure involves severing the small intestine, pulling up the top of the bottom section to connect to the new small stomach. The upper section of the small intestine, still connected to the unused stomach portion area, still receives bile and digestive juices from the liver and pancreas. So its bottom end is connected (in a Y connection) to the small intestine about three feet downstream. This allows digestive fluids to act on material coming through the reconfigured small intestine before entering the large bowel.
The Roux-en-Y gastric bypass can be performed either with an open incision or by laparoscopic technique, the latter offering improvements in patient discomfort and length of hospital stay. It should also be noted that some candidates for surgical treatment have such impaired health that they must be hospitalized pre-operatively and undergo treatment to improve their operative risk.
To locate a Lourdes Health System bariatric surgeon by phone, call 1-888-LOURDES.
