Fobi Pouch
The Fobi pouch is a type of bariatric surgery that is very similar to the roux-en-y except that it uses a silastic ring to create the pouch instead of staples. The new pouch is transected, that is, completely separated from the old stomach. This is different from the previous method of simply making a staple line across the stomach. This procedure also uses an imbricated gastrojejunostomy. A what? Ok, once we get into the re-routing of intestines, things get pretty complicated and the words get very long, but we'll try to make it easy for you!
An imbricated gastrojejunostomy means that The limb of the jejunum that is brought up to form the gastroenterostomy is used to imbricate the transected edge of the proximal pouch thus diminishing the possibility of leaks and subphrenic abscess.
Let's break that down a little more:
limb - section
jejunum - the section of the small intestine that comprises the first two fifths beyond the duodenum
duodenum - the first, shortest, and widest part of the small intestine
gastroenterostomy - passage between the stomach and small intestine
imbricate - overlap
transected - separated
subphrenic - area below the diaphragm
abscess - a localized collection of pus surrounded by inflamed tissue
So,
Part of the tissue of the second section of the small intestine is brought up to the opening of the new pouch (which is separated from the stomach) and overlaps the separated area, which helps reduce possible leaks at the separated area and abscesses in the area below the diaphragm.
The area also has a silastic ring to make it easier for doctors to find the site if they need to get to it radiologically, endoscopically, or for enteral (tube) feeding.
This variation on the roux-en-y was developed by Dr. Mal Fobi to address some of the problems that occur with the regular RNY, like marginal ulcers at the site of the staples and stretching of the pouch. The Fobi pouch has been quite popular with celebrities opting for gastric bypass.
Here are some other pages you may find interesting:
- Roux-en-y Procedure
- Lap Band
- Lap Band vs Gastric Bypass
- Mini Gastric Bypass Surgery
- Vertical Banded Gastroplasty
Return to the Gastric Bypass Guru from Fobi Pouch
