During this surgical procedure, the stomach is divided into two compartments. The upper part of the stomach, called a pouch, receives the food that you eat. This new pouch is approximately 15-30 cubic centimeters (or the size of a golf ball). While the surgery reduces the capacity of the stomach by 90-95 percent, no part of the stomach is removed or cut away.
Click the image above to view the Roux en Y Gastric Bypass procedure (7.5MB)
Next, an outlet, called a stoma, is created in the small stomach pouch. This outlet is about 12 millimeters in diameter - about the size of a dime. The food a person eats must be able to pass through this opening, which is why it must be chewed very well. The upper small intestine is then divided and joined to the new stoma. Food bypasses the lower part of the stomach and part of the small intestine (which is why the surgery procedure is also known as the "gastric bypass"). Digestion occurs in the lower intestine.
Common Questions about Roux en Y Gastric Bypass
What happens to the larger stomach partition that is no longer used?
The larger, lower part of your stomach no longer receives food, but its gastric juices from this part of the stomach pass into the intestine and mix with food as they did before surgery.
Can the stoma (pouch outlet) narrow down and cause vomiting?
Patients heal at different rates and scar differently. In some patients, scarring at the pouch’s outlet can cause their outlet to narrow. This is called "Stomal Stenosis" and is usually managed by endoscopic dilatation by a patient’s surgeon within the first months after surgery. This may be more common in patients who have the operation performed laparoscopically, than in those patients who have the operation done "open" with an incision.
Why are staples used in surgery?
Staplers have been used in abdominal surgery for the past 30 years, and there are few gastrointestinal operations done without them. In the Roux-en-Y gastric bypass, a special type of cutting stapler is used when the stomach is completely divided to create the stomach pouch. It is also used to divide the small intestine. Compared to old-fashioned methods, the use of the cutting stapler allows fast, clean and precise division of the stomach and intestine. Each cut staple line is then reinforced with sutures.
As healing progresses over the three to four week period after your surgery, tissue grows over the staples. They are there permanently and will show up on an x-ray, but they play no roles in the long-term outcome of the operation, nor are they associated with any ill effects. This is not to be confused with the operation commonly called "stomach stapling", which uses staples in a far different manner.
Internal staples are not removed. Talk with your surgeon if you have any questions about your surgical procedure.
Will the staples set off the metal detector or the security alarm at the airport?
It is highly unlikely that the internal staples described above will set off a metal detector at the airport. It is recommended, however, that if you ever require a test called magnetic resonance imaging (MRI), you tell the people performing the test that you have internal staples.
How long will it take me to recover from surgery?
Recovery from surgery generally takes about six weeks. Your stomach pouch is swollen after surgery; however, the swelling will soon subside. It will take about three months for your stomach to heal fully.