How Divided Gastric Bypass Surgery Is Performed

The divided gastric bypass with Roux-en-Y gastrojejunostomy consists of separating the stomach into two sections using parallel rows of titanium staples, with the staples additionally over-sewn or secured with sutures as needed. The staples remain in place. The small upper segment connected to the esophagus remains the functional portion of the stomach, while the larger lower segment connected to the duodenum becomes the non-functioning portion of the stomach.

In the next phase of the surgery, the surgeon separates most of the small intestine from the stomach and brings one end up to the small upper segment of the stomach which is still connected with the esophagus. This section of the intestine is still functional. When the intestine is connected to this small stomach pouch, the opening is about the size of a dime. This allows food to pass directly into the intestine, where it is digested.

Following the connection, the small intestine is then reconnected in the shape of a “Y” (that’s why it is called Roux-en-Y) about 40 inches below the first. Digestive juices form in the lower, now non-functional, segment of the stomach and the duodenum and empty into the small intestine at the “Y.” Thus, food that enters the small upper stomach pouch will mix with secretions from the lower stomach pouch and duodenum. From here on, digestion and absorption of food nutrients are carried on in a completely normal way.

How Laparoscopic Gastric Bypass Surgery Is Performed

Laparoscopy is a procedure in which a tube is inserted through a small incision into the abdomen. Carbon dioxide gas is gently pumped into the abdomen to expand it. A tiny video camera is inserted through the tube, allowing a surgeon to “see” into the abdomen by watching a monitor. The surgery is performed by the surgeon watching the monitor and using surgical instruments that have been inserted through other laparoscopes.