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The Roux-en-Y laparoscopic gastric bypass, first performed and reported on in case studies between 1993 and 1994, [3] is regarded as one of the most difficult procedures to perform by limited access techniques.
Schematic of gastric bypass using a Roux-en-Y anastomosis. The transverse colon is not shown so that the Roux-en-Y can be clearly seen. The variant seen in this image is retrocolic, retrogastric , because the distal small bowel that joins the proximal segment of stomach is behind the transverse colon and stomach.
It has been found to produce a weight loss comparable to that of Roux-en-Y gastric bypass. [17] The risk of ulcers or narrowing of the gut due to intestinal strictures is less so with sleeve gastrectomy versus Roux-en-Y gastric bypass, but it is not as effective at treating GERD or type 2 diabetes. [17]
Combined restrictive and malabsorptive techniques are called gastric bypass techniques, of which Roux-en-Y gastric bypass surgery (RGB) is the most common. In this technique, staples are used to form a pouch that is connected to the small intestine , bypassing the lower stomach, the duodenum , and the first portion of the jejunum .
The Roux-en-Y gastric bypass (RYBG), a modification of the original gastric bypass, was both a restrictive and malabsorptive surgery and became the preferred method. It reduced the size of the stomach and limited the number of nutrients the body absorbed by bypassing a portion of the small intestine, resulting in better long-term weight loss.
An adjustable gastric band is an inflatable silicone prosthetic device that is placed around the top portion of the stomach. This procedure can be performed as a revision procedure for many patients who have had a previous stomach stapling, gastroplasty procedure, or Roux-en-Y gastric bypass surgery but have regained weight.
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