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Laparoscopic Roux-en-YGastric Bypass(LRYGB)
The Laparoscopic Roux-en-Y Gastric Bypass (LRYGB) is considered to be the “gold
standard” procedure by the American Society of Bariatric Surgeons (ASBS). This operation
is the most commonly performed and has a proven record for significant weight loss.
There are many different techniques that can be used for the LRYGB, all of which
are acceptable. When the procedure is done laparoscopically, 5 to 7 small incisions
are made. A camera, called a laparoscope, and long surgical instruments are used
while the belly is inflated with carbon dioxide gas. The surgeon then operates while
visualizing the internal organs on a television screen. During the LRYGB, a 30-60cc
pouch is created by stapling-off the stomach. The remaining stomach stays alive
and intact, and the far end is attached to the small bowel. This “remnant stomach”
receives blood and produces digestive stomach acid. A 40cm section of small bowel
is then measured, cut, and reattached to the stomach by stapling, hand stitching,
or a combination of the two. Another 100-200cm of small bowel is then attached to
the side of the limb to drain the new, small stomach pouch.
Weight loss from this procedure averages 60-80% loss of excess body weight. The
LRYGB is highly effective because patients not only eat less and feel full quickly,
but they also do not fully absorb the food they eat. Doing the procedure laparoscopically
results in a decreased morbidity and shorter hospital stay when compared to the
open procedure. Most patients are discharged home in 2-4 days.
Complications:
Death in 1 in 300 depending upon BMI and medical problems
Pulmonary embolism
Leakage from bowel
Abscess
Hemorrhage
Bowel Obstruction Obstruction of the Stomach Outlet
Pneumonia
Wound Infection
Urinary Tract Infection
Chronic Nutritional Problems
Protein Deficiency
Vitamin and Mineral Deficiency
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