The Roux-en-Y gastric bypass operation is the oldest and best known form of weight loss surgery and, despite the fact that other procedures have been developed in recent years, it still remains a firm favorite with many patients. It is also one of the few forms of weight loss surgery which the majority of insurance companies will authorize without too much difficulty. In many ways the success of the Roux-en-Y lies in the very fact that it has been around for many years and so has a proven track record. It is also a procedure which many bariatric surgeons have grown up with and are skilled at practicing. This said, the Roux-en-Y has not 'stood still' and today an increasing number of surgeons are performing this traditionally open form of surgery laparoscopically. The Roux-en-Y involves a three stage process. First, the stomach is divided to create a small portion, or pouch, to act as the new 'working' stomach. This severely restricts the amount of food that the patient can eat and so the calories that can be introduced into the body. Next, the intestine is divided so that about fifteen to twenty percent of the small intestine is bypassed, shortening the normal twenty feet of intestine to approximately sixteen or seventeen feet. Finally, the bypassed section of the small intestine is connected to the lower intestine to allow the necessary digestive juices to mix with food as it passes through the intestine. The principal of the Roux-en-Y gastric bypass is that it creates weight loss by both restricting the quantity of food which the patient can eat and reducing the absorption of calories from food passing through the digestive system. It is this reduction in the absorption of calories within the digest system which makes the Roux-en-Y a better option for some patients than simple restrictive surgery such as laparoscopic gastric banding. The bypass in the case of the Roux-en-Y is also relatively short and this makes it a safer option than surgeries involving a duodenal switch and far greater bypass of the intestinal tract. Like any other form of surgery, Roux-en-Y gastric bypass surgery is not without its risks but, overall, these are considered to be acceptable to most patients and a fair price to pay for some excellent results, which can typically see a loss of about seventy percent of excess weight.
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