As said before when we aare choosing a surgical procedure we take into account each patient characteristics, age, gender, associated diseases such as diabetes, acid reflux, jsut to name a few, these facts however play an important role in deciding which procedure a patient is going to have. Here are some of the facts regarding gastric bypass surgery:
Roux en Y Gastric Bypass (RYGB).
- It is a mixed procedure restrictive and malabsorbtive. It diminishes stomach capacity and reroutes food transit from the diminished stomach into a distant part of the small bowel, limiting absorption of nutrients and calories.
- Alters digestive anatomy significantly.
- Discrete better outcomes in the long term of % Excess Weight Loss and resolution of obesity related diseases compared to Gastric Sleeve (GS),[1,2].
- Better diabetes control in patients in mild or moderate diabetes. (Patients with severe diabetes can achieve similar results with a RYGB or GS) ,[2].
- Better acid reflux control/resolution [3].
- Very good % Excess Weight Loss in Higher BMI population.
- Although discrete, it has more reported complications than sleeve gastrectomy within the first 30 postoperative days,[4]
- Morbimortality (complication rate) 0 -17.5% [5].
1. Leyba JL, Llopis SN,Laparoscopic Roux en Y gastric bypass versus laparoscopic sleeve gastrectomy for the treatment of morbid obesity. A prospective study with 5 year followup of 117 patients Obes Surg 2011:21;212-16.
2. Jackson TD, Huttler MM. Morbidity and effectiveness of laparoscopic sleeve gastrectomy, adjustable gastric banding and gastric bypass for morbid obesity. Adv Sure: 2012;46:255-68
5. FisherL, Weckerle AL, Bruckner T, et al, BariSurg trial, sleeve gastrectomy versus roux en y gastric bypass in obese patients with vmi 35 – 60 kg/M2 a multi centre randomized patient and observer blind non inferiority trial.BMC Surg 2015;15:1-8.
Dr Galileo Villarreal
Bariatric Surgeon