How is Roux en Y Gastric Bypass Surgery Performed?

Roux en Y gastric bypass surgery has been actively used for the last 50 years as it is a surgical procedure that provides successful results in the treatment of obesity. Roux en Y gastric bypass surgery, which is one of the most frequently performed bariatric surgery operations worldwide, helps to reduce the stomach volume of the patient and to restrict absorption. Thus, the amount of food consumed by the patients is reduced and some of the consumed nutrients are thrown out of the body without being absorbed. 

As is the case with all types of obesity surgeries, Roux en Y gastric bypass surgery is applied to patients who cannot lose weight despite regular diet and exercise and have overweight problems. Excess weight that cannot be lost with regular diet and exercise is lost by patients in a short time and without causing much strain after Roux en Y gastric bypass surgery.

How is the Roux en Y Gastric Bypass Surgery Process?

Since Roux en Y gastric bypass surgery is performed by laparoscopic method, no large incision is required. It is sufficient to make 6 incisions, all under 1 cm, to perform the surgery. The operation area is reached by passing special tools and cameras through the opened incisions, which will enable the operation to be performed. 

A small stomach called stomach pouch is created at the entrance of the stomach. The volume of the gastric pouch is about 35 to 50 cc, which is less than a small tea cup. In patients with a normal stomach volume of 800 to 1000 cc, the stomach volume is reduced by 95% after this application. 

After the stomach pouch is formed, a pathway is needed to ensure that the food passes from there to the intestines. The first step in creating this pathway is to cut the small intestines at an average of 50 to 75 cm. After the end, which is continued downward, is pulled upwards, it is connected to the new stomach pouch. Thus, the food taken is brought to the new stomach pouch, and the old stomach, which has never met food, becomes passive. Since the food coming into the new stomach pouch passes directly to the small intestine, a part of the small intestine with the remaining stomach is separated from the food passage and does not come into contact with the food at all. This process applied prevents the absorption of all nutrients and facilitates weight loss.

The secretions of the stomach, which is separated from the passage of food, and the small intestines that continue in connection with it, must somehow flow to the rest of the small intestine. This is necessary for the absorption of nutrients and some minerals needed to maintain a healthy life. In addition, if this connection is not made to the intestine, various problems may occur. The section at the beginning of the small intestine, which does not pass food through, is made to function as a conduction channel only for bile and pancreatic secretions. The end of this small intestine is adjusted so that it is in the middle of the small intestine that connects to the new stomach.

How Does Roux en Y Gastric Bypass Surgery Work?

Roux en Y gastric bypass surgery has many different mechanisms of action. One of them is the volume of the gastric pouch. With Roux en Y gastric bypass surgery, the patient’s stomach volume is reduced by approximately 90% to 95%. Although the stomach of a normal person can stretch up to 1000 cc, it is possible for this capacity to increase up to 1500 cc depending on the increase in the size of the obesity. The new stomach created by Roux en Y gastric bypass surgery has a volume of 35 to 50 cc. Because the stomach is so compacted, it takes very little food. When the stomach is filled with food and the stomach wall starts to stretch, a signal goes to the fullness center and the person feels full. 

Food passes from the small stomach pouch to the small intestine, triggering the secretion of a wide variety of hormones from the small intestine. Hormones released from the small intestine, namely incretins (Peptide-YY, GLP-1, Cholecytokinin) undertake the task of providing an early feeling of being full. The feeling of being full created by incretins also positively affects the use of absorbed simple sugar. The GLP-1 hormone, which is secreted excessively as a result of the early arrival of the food in the ileum, the last part of the small intestine, contributes to the normal level of blood sugar in people with diabetes, regardless of the drug.

All the activities that the body performs for life are called metabolism. Although some of them are voluntary movements and behaviors, most of the metabolism consists of the work done by all tissues, from organs to individual cells, without the person being aware of it. While the energy need decreases in the resting state, there is a need for energy for all basic vital activities. This energy is met from sugar and fat stores in the body when food is not consumed. Resting energy expenditure increases in patients who have had Roux en Y gastric bypass surgery.

Roux en Y gastric bypass surgery only provides more permanent and effective mechanisms that cannot be explained by restricting the amount of food consumed or by not absorbing some of the nutrients. Patients feel less emotional desire to eat, and the advantage of reaching a state of metabolic balance and saturation throughout the body is achieved.