LAPAROSCOPIC AND TRADITIONAL ROUX-EN-Y GASTRIC BYPASS

The laparoscopic Roux-en-Y gastric bypass is our operation of choice. It is similar to the traditional or “open” procedure except for the size of the incision and the ability to make a smaller more precise gastric pouch due to the superior visualization afforded by laparoscopy. The stomach pouch is very small (10-20 ml). Food bypasses most of the stomach and duodenum and empties directly into the “Roux limb”. The number of calories that you can ingest in initially limited to the size of the stomach pouch. A small amount of food will give you a feeling of “fullness”. Later, although the pouch remains the same size, it functions as a “virtual stomach”. Patients can enjoy eating the equivalent to a small sandwich or a few slices of pizza. Long-term weight reduction and maintenance is achieved not by building an aversion to food, but by changing one’s relationship with food. Many of our patients simply “do not feel hungry”. They stop eating because they are “full”. Drinking is not affected as liquids pass through the pouch very quickly.

Although the “open” Roux-en-Y gastric bypass has become one of the most common bariatric procedures, the laparoscopic approach requires additional surgical skills in laparoscopy.

The major long-term nutritional consequences are mostly due to decreased iron and calcium absorption and can be overcome with oral supplementation if necessary. Iron and calcium are absorbed mostly in the duodenum and the first part of the small intestine and therefore we try to keep this limb as short as possible.

Advantages of the laparoscopic procedure over traditional surgery includes: less pain and faster recovery, less chance of incisional hernia formation, and incisions that are more cosmetic. We now perform the vast majority of procedure this way. Exclusion from this approach is rare. At this time, we feel this is the best method for most patients.

The laparoscopic Roux-en-Y gastric bypass is performed through five _inch incisions and takes approximately 45-75 minuets to complete. Average hospital stay is 1 to 2 days. You can expect to return to work in one to three weeks following the procedure.