 Roux-en-Y gastric bypass provides gastric restriction combined with malabsorption. Currently, it is the most frequently performed operation for morbid obesity in the U.S.A. By adding malabsorption, food is delayed in mixing with bile and pancreatic juices that aid in the absorption of nutrients. The result is an early sense of fullness, combined with a sense of satisfaction that reduces the desire to eat.
The stomach is divided by a surgical stapler, creating a pouch the same size as other pure restrictive operations. The remainder of the stomach is not removed, but is completely stapled shut and divided from the stomach pouch. The outlet of the pouch opens into intestine rather than into the rest of the stomach. This is done by dividing the small bowel just beyond the duodenum and bringing it up to the pouch to construct a connection. The other open end of the bowel is sewn back into the side of the Roux limb of intestine, completing a Y-shaped arrangement that gives the technique its name. The length of either segment of bowel can be increased to produce more malabsorption, but this also increases the risks and side-effects.
According to the American Society for Bariatric Surgery and the National Institutes of Health, Roux-en-Y gastric bypass is the current gold standard procedure for weight loss surgery.
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