Gastric bypass goes by many names. Its full name is “Roux-en-Y gastric bypass” (pronounced “roo-on-why”) because of its Y-shaped intestinal connection. For many years, gastric bypass was considered to be the gold standard operation against which all other bariatric procedures were measured. Although gastric bypass is no longer the most common bariatric operation performed, it is still the best operation for many people, particularly if you have type II diabetes or severe reflux or GERD.
What Exactly is the Gastric Bypass?
The gastric bypass has been around for a long time – over 50 years! It has been demonstrated over and over to provide an excellent balance of weight loss and manageable side effects. It is very powerful in treating type II diabetes (T2DM) and gastro-esophageal reflux, or GERD. For these reasons, the gastric bypass is considered by many surgeons and patients alike to be one of the best options in weight loss surgery.
The operation is usually performed using minimally invasive, laparoscopic technique. This means that you have around 5 ot 6 very small incisions in the abdominal wall. Recovery is much easier and faster after laparoscopic surgery than it was back in the old days when a traditional open incision was used. At Mount Sinai, we prefer the laparoscopic approach for almost all patients because of decreased pain, faster recovery, quicker return to normal activities, and a lower incidence of incision-related problems like infection or hernia.
In the Roux-en-Y gastric bypass procedure, a surgical stapler is used to separate the upper portion of the stomach from the lower portion. The upper portion, about the size of an egg, is referred to as the “pouch,” and is the only part of your stomach that food enters into. Because the pouch is so small, you feel full after eating just a small amount. The pouch is then connected directly to a piece of your intestine which we surgically connect to it; this is called the “Roux limb.”
The lower part of your stomach is not removed. It stays there and continues to make stomach acid and digestive juices which help you digest your food. These digestive juices pass through the biliopancreatic limb of the intestine separate from the food. Food doesn’t mix with the digestive juices until the Y-junction where the intestines connect to form the “common channel.”