1 March 2019 The procedure works by limiting the amount of food ingested and altering absorption. What is the surgical procedure for the Roux-en-Y gastric bypass? In this operation, a small gastric pouch is created with a capacity of between 15 and 30 mL, which aims to significantly limit ingestion capacity. The pouch is connected to the small intestine in the area of the jejunum. It bypasses the duodenum, thereby impeding the action of the pancreatic and biliary secretions. Roux-en-Y gastric bypass: advantages and disadvantages With a gastric bypass, the amount of the small intestine removed from the digestion/absorption process is substantially less than that of malabsorption inducing techniques (duodenal switch and Scopinaro procedure). The benefits of this surgical procedure are: It can be carried out laparoscopically by robotic surgery; It is more effective than the restrictive procedures (gastric band and sleeve gastrectomy) in terms of weight loss; It is more effective in reducing or eliminating comorbidities, particularly diabetes and high blood pressure, than restrictive procedures; It does not cause serious nutritional deficiencies, in particular protein shortages; It does not cause side effects such as diarrhoea, flatulence or foul-smelling stools; It does not involve any gastric resection and is therefore reversible; It does not require the placing of a foreign body in the abdominal cavity. The Roux-en-Y gastric bypass has the intentional side effect of dumping syndrome , which results in unpleasant symptoms when food with high fat and sugar content is ingested. How do you process weight loss with the Roux-en-Y gastric bypass? As the gastric pouch is very small after this procedure, the volume (about half a teacup) and the frequency of meals (4 to 6 per day) are very important. Food should be eaten in small portions , spaced out over a few minutes, chewed carefully and swallowed slowly. Rapid or excessive intake may result in discomfort or vomiting. With the gastric bypass, weight loss is brought about by at least 3 mechanisms: Reduced intake; Reduced absorption; Dumping syndrome. It is possible that a fourth mechanism, the action of a hormonal nature, may also be involved by inhibiting the appetite ; however, this is not completely clear and is still being researched. Are the results of this intervention significant? The results of gastric bypass surgery are very good, particularly when compared to purely restrictive procedures (gastric band or sleeve gastrectomy). The effects on the absorption of essential microelements is minimal, and there is no effect on the absorption of proteins. It is customary, however, for those undergoing the procedure to take vitamin supplements for life. Roux-en-Y gastric bypass is the preferred operation in the majority of centres dedicated to and specialising in surgical obesity treatment in the Western world, and in Europe and the United States of America in particular. It is considered the gold standard for the surgical treatment of obesity. Obesity surgery, or bariatric surgery, is performed by general surgeons. This article was written with the support of physicians and other clinical professionals from the Hospital da Luz network. The content published in the Health Guide is intended for the general public and is provided for informational and educational purposes only. It does not replace individual medical assessment, diagnosis, or personalized clinical advice from a qualified healthcare professional. The content is produced or reviewed by physicians and other healthcare professionals at Hospital da Luz and is based on the knowledge available at the time of publication or the most recent update, as indicated at the beginning of each item.
