Overview

The Roux-en-Y Gastric Bypass is considered the gold standard in bariatric surgery. It involves creating a small stomach pouch (about the size of an egg) and connecting it directly to a section of the small intestine (jejunum), bypassing most of the stomach, the duodenum, and a portion of the small intestine.

Mechanism of Action

• Restrictive: Small stomach pouch limits food intake.

• Malabsorptive: Bypassing a segment of the intestine reduces calorie and nutrient absorption.

• Hormonal Effects: Improves insulin sensitivity; early remission of type 2 diabetes is common.

Benefits

• High success rate in weight loss (60–80% excess weight loss).

• Excellent results in controlling type 2 diabetes, even in patients with lower BMI.

• Improvement or resolution of obesity-related conditions: sleep apnea, GERD, hypertension.

Risks/Complications

• Higher surgical complexity.

• Risk of dumping syndrome (nausea, diarrhea, weakness after eating sugar).

• Higher risk of vitamin/mineral deficiencies (e.g., B12, iron, calcium, vitamin D).

• Risk of internal hernias, ulcers, or bowel obstructions.

Ideal Candidates

• Patients with severe obesity (BMI ≥ 40).

• Patients with significant comorbidities, especially type 2 diabetes.

• Those who failed previous restrictive surgeries (e.g., gastric band, sleeve).