| Diagram of Proximal RNY Procedure |
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Proximal Roux-en-Y
gastric bypass. (from Sugerman HJ, Starkey J,
Birkenhauer R. A randomized prospective trial of
gastric bypass versus vertical banded
gastroplasty for morbid obesity and their effects
on sweets versus non sweets eaters. Ann Surg 1987;
205:613-624; with permission.) |
The gastric bypass has been shown to be the best
surgical procedure for the treatment of severe obesity.
The main aim of the operation is to reduce the capacity
of the stomach to only 30cc (equivalent to two
tablespoons) by stapling across the stomach with a
special metal device. Thus, approximately 90% of the
stomach is below the staple line and is therefore
isolated from the passage of food through the stomach. A
length of small intestine (typically 50-100cm) is stapled
to the stomach above the staple line so that food passes
from the 30 cc gastric pouch directly into the small
intestine. The severely reduced size of the stomach in
combination with the narrow diameter (1cm) of the
connection between the gastric pouch and the small
intestine are responsible for significant limitations
placed on the patientís ability to eat large meals after
the operation: these factors then allow the patient's to
lose over 75% of their excess body weight over the first
18-24 months after surgery 
I had a 150cm
bypass, which allows 20-50% malabsorption. It is
important to note that people who have these surgeries
must maintain a strict nutritional regimen on a daily
basis, this includes a minimum amount of protien daily in
addition to nutritional supplements. 
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