The Roux en y Procedure
The roux en y procedure is a type of obesity surgery, and is considered at this time to be the gold standard in bariatric procedures. It's main competitor in the world of obesity surgery is the adjustable gastric lap band, and we have a page just for the debate of lap band vs gastric bypass.
This is a restrictive/malabsorptive combination procedure, and the re-routing of the intestines is a little on the complicated side, but we'll try to explain it as simply as possible.
Figure 1
An overall diagram of the roux en y procedure, sketched by The Guru.
First remember that our digestive system is like one very long tube that starts in our mouth, goes through the esophagus, into the stomach, through the small and large intestines, and ends at the anus. Along that route, the fat, calories, vitamins, proteins, etc. are absorbed into our body and used for energy. When we consume more than we can use, the rest is stored on our bodies as extra weight.
Food travels down the esophagus and into the stomach. Normally it stays in the stomach for a bit, mixing together and mixing with digestive juices that begin to break down the protein (this is one of the reasons patients with a malabsorptive surgery like the roux en y procedure must concentrate on getting enough protein. We are now missing this part of the normal digestive process).
Figure 2
In the roux en y procedure the new pouch is a fraction of the size of the old stomach.
sketched by The Guru
Next, the food goes into the first part of the small intestine, called the duodenum, where most of the chemical process of digestion takes place, including the digestion of fat, and the absorption of iron.
What hasn't yet been absorbed now heads to the jejunum, where it finishes the absorbing process. The "leftovers" now head to the large intestine, or colon, which absorbs any remaining water and then sends the remaining waste on its way, resulting in a bowel movement.
Figure 3
the cut end of the intestine is attached to an opening at the bottom of your new pouch.
sketched by The Guru
In the roux en y procedure (figure 1), a part of the stomach is sectioned off from the rest (see figure 2). The small intestine is cut somewhere past the jejunum (where depends on whether you have a proximal or distal procedure) and the cut end is then brought up to an opening made in your new stomach - your pouch (see figure 3). This is why it's called gastric bypass - your food will now bypass the duodenum.
Figure 4
The intestine is attached to the jejunum, forming the "Y".
sketched by The Guru
An opening is made in the part of the intestine that was brought up, and attached at that opening to the jejunum (see figure 4). This is the "Y" part of the roux en y procedure.
Because we don't absorb fat as well as before, we sometimes have flatulence or diarrhea issues if we eat foods containing too much fat. We also have to take iron supplements to make up for the absorption we're missing out on in the duodenum.
Here are some other pages you may find interesting:
- Lap Band
- Fobi Pouch
- Lap Band vs Gastric Bypass
- Mini Gastric Bypass Surgery
- Vertical Banded Gastroplasty
Return to the Gastric Bypass Guru from Roux en Y Procedure
