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The gastric bypass reduces the size of the stomach by well over 90%. [4] A normal stomach can stretch, sometimes to over 1000 mL, while the pouch of the gastric bypass may be 15 mL in size. The gastric bypass pouch is usually formed from the part of the stomach that is least susceptible to stretching.
After performing gastric bypass surgery, the two hormones related to obesity, leptin and insulin, fall in levels and while lose weight. [13] Roux-en-Y (RYGB) offers two surgical approaches for processing: an open technique or the laparoscopic technique. The majority of cases are still performed with laparoscopy. [13]
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.
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 .
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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[3] [2] Post-gastric bypass hypoglycemia can be prevented by eating smaller, more frequent meals, avoiding sugar-filled foods, as well as medical treatment with an alpha-glucosidase inhibitor, diazoxide, or octreotide. [3] [2] Some causes of hypoglycemia require treatment of the underlying cause to best prevent hypoglycemia. [2]
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