Roux-en-Y gastric bypass surgery

In this procedure, the stomach is divided into two sections. A pouch is formed from the upper end of the stomach that is about the size of a small egg.

This small pouch is divided from the rest of the stomach using a surgical stapling device that places rows of titanium staples across the division.

Then the small intestine is divided at the early part of the jejunum. The lower jejunum is then brought up and connected to the new small gastric pouch.

The connection of the stomach to this length of jejunum is called a gastrojejunostomy.

After the gastrojejunostomy is performed, the remaining large portion of the stomach and length of intestine attached to it must now be allowed to drain.

The surgeon connects this section "downstream" from the gastrojejunostomy. This connection is called the Roux-en-Y jejuno-jejunostomy.

These changes both restrict the amount of food that can be eaten at one time, and to a much lesser extent, decrease the amount of calories and nutrients the small intestine can absorb from food.

In summary, following a Roux-en-Y surgery, food enters the esophagus and is transported into the stomach pouch. The amount of food that can be eaten at one time is limited due to the small size of the pouch.

This food enters the Roux limb and progresses down to the “Y connection” to where the bile and pancreatic juices empty into the small intestine.

Digestion begins here at what is called the “common channel”. From the Roux-en-Y connection onward, digestion occurs in the usual way.