Laparoscopic Roux-en-Y Gastric Bypass: Surgical Technique and Tips for Success

Abstract

Obesity is a worldwide increasing concern, and its prevalence has risen rapidly over the past several decades. Since nonsurgical treatment for weight loss in morbidly obese patients has poor long-term outcomes, bariatric surgery has gained acceptance and popularity in the last years. The laparoscopic Roux-en-Y gastric bypass has proved to be safe and effective, with successful long-term outcomes in morbidly obese patients. Key elements for the success of the operation are careful patient selection, a comprehensive preoperative evaluation, and a properly executed operation that respects the key technical elements.

Bariatric surgery and the liver—Mechanisms, benefits, and risks

“…BS aims at reducing body weight and improving health of patients with class 2 or higher obesity. 14 The most commonly applied techniques are the RYGB and sleeve gastrectomy (SG). In the former, most of the stomach is bypassed by creating a small gastric pouch (6 to 8 cm in length and 4 to 6 cm in width).…”

“…A gastrojejunostomy is performed, obtaining the alimentary limb, whereas the gastric remnant forms the proximal end of the biliary limb and is connected by jejunojejunostomy, thus forming the common limb. 14,15 The exact limb length differs slightly by technique and center preference, with the alimentary limb measuring 100 to 150 cm and the biliary limb measuring 70 to 150 cm. 14 SG, on the other hand, implies the resection of the greater gastric curvature, leaving a narrow gastric tube along the lesser curvature, accounting for 10% of the stomach volume.…”

“…BS aims at reducing body weight and improving health of patients with class 2 or higher obesity 14 . The most commonly applied techniques are the RYGB and sleeve gastrectomy (SG).…”

“…In the former, most of the stomach is bypassed by creating a small gastric pouch (6 to 8 cm in length and 4 to 6 cm in width). A gastrojejunostomy is performed, obtaining the alimentary limb, whereas the gastric remnant forms the proximal end of the biliary limb and is connected by jejunojejunostomy, thus forming the common limb 14,15 . The exact limb length differs slightly by technique and center preference, with the alimentary limb measuring 100 to 150 cm and the biliary limb measuring 70 to 150 cm 14 .…”

Energy imbalance: obesity, associated comorbidities, prevention, management and public health implications

“…HTN, T2DM, and dyslipidemia were also significantly improved after LRYGBP. [131][132][133][134] LRYGBPprocedures are minimally invasive procedures that are safe, feasible, and preferred over open RYGBP because of the short hospital stay and low perioperative morbidity. Additionally, weight loss after five years of LRYGBP is markedly improved; a study showed that, in a 5-year period, of the 1160 patients who had a LRYGBP, 240 had T2DM or impaired fasting glucose.…”