Gastric Bypass/Roux-en-Y gastric bypass
Procedure:
First a small gastric pouch is created to restrict food intake. Next, a Y-shaped section of the small intestine is attached to the gastric pouch. So food bypasses the remnant stomach and the first intestine segments are bypassed. A second connection to the intestine segment is performed where the digestive enzymes are added to the food pulp. This procedure limits the amount of food intake in addition to a reduced absorption capability of nutrients and calories. Moreover a later expansion of the pouch can be overcome by implantation of a non-adjustable band (banded bypass) resulting in an extra 20% excess weight loss.
Hospital stay: 2-3 days
Excess weight loss: 50-70% in 2 years (60-90% banded gastric bypass)
Advantages of Roux-en-Y gastric bypass:
After undergoing a Roux-en-Y gastric bypass surgery a more rapid initial weight loss occurs when compared to other surgical techniques such as laparoscopic-adjustable gastric banding or sleeve gastrectomy. This technique combines a restriction of food intake with a reduction of the functional absorptive intestinal length, leading to a mild malabsorption. Furthermore it is also applicable in patients with a sweet eating or binge eating behavior. In contrast to laparoscopic-adjustable gastric banding no drastic change of diet is required.
Disadvantages of Roux-en-Y gastric bypass:
In comparison to gastric banding or sleeve gastrectomy, Y-en-Roux gastric bypass surgery is more complex and a bigger intervention. Life-long intake of vitamins and minerals are necessary as well as vitamin B12 injections every 6 months. A conventional upper gastroscopy of duodenum, remnant stomach and biliary tract is not possible after this type of surgery. Side effects include the dumping syndrome, vertigo and temporary discomfort. Repetitive dietary mistakes lead to a reduced weight loss.