The Roux-en-Y gastric bypass is a procedure I commonly do. It is not as common as the gastric sleeve, or the 'omega loop'/one anastomosis bypass, but it does suit certain people, specifically a group of people who suffer from reflux.
Best for reflux It is a very strong bariatric procedure (effective for weight loss) and also probably the most definitive operation for reflux.
The first The Roux-en-Y gastric bypass is the longest formally documented weight loss procedure around.
Can be done through small incisions The laparoscopic method of surgery makes small incisions to perform the procedure. The other method is 'open' meaning a larger incision. Where the anatomy supports it, the laparoscopic method is preferred as the healing time after surgery is faster (the wound is smaller).
Its more complex It is also more complicated than other types of weight loss surgery because there is more involved in the operation. Essentially it involves creating a small gastric pouch at the top of the stomach which reduces the food that can be eaten. The bowel is divided making a smaller bowel (approx 1 metre). The small pouch is the directly connected to a part of the bowel called the Roux limb.
The "y" shape The new smaller stomach pouch is connected to the divided bowel and this forms the shape of a '"y" which gives the procedure its name. With this, food bypasses the rest of the stomach and the upper part of your bowel.
Greater care to prevent ulcers There is a higher rate of ulcers at the join between the small bowel and stomach so monitoring reflux medication is very important.
Possibility of internal hernias At the join between the small bowel and stomach there is the possibility of developing internal hernias.
Reversible This procedure can be reversed if required.
Regardless of whether it is a Roux en-Y gastric bypass, a sleeve gastrectomy or single anastomosis bypass there are several critical things to ensure long-term success of bariatric procedures. In order for the surgery to be successful in the long term it needs to be accompanied with a combination of dietary modification and a change in the way people eat.
Dr Neil Wylie is a Bariatric and General Surgeon who operates privately at St Andrew's Toowoomba Hospital and St Vincent's Hospital Toowoomba. He is a member of the Royal Australasian College of Surgeons, the Australian & New Zealand Metabolic and Obesity Surgery Society and the Australian New Zealand Hepatic, Pancreatic and Biliary Association.