Rancocas Valley Surgical Associates - The Gastric Bypass Operation

The Gastric Bypass Operation

The Gastric Bypass Operation creates a small (15-30cc) proximal gastric pouch which is separated from the rest of the stomach. A silastic band is placed around the outflow of the pouch acting as a pseudo pylorus to maintain long term control of the pouch emptying into a 100 cm long Roux-en-y limb of small intestine. For some patients, the roux-en-y limb of small intestine can be 250 cm or longer to add a malabsorptive component to the procedure.

Physiological Effects of Surgery

The small gastric pouch produces a feeling of satiety when it becomes filled with a very small amount of food. The band on the outflow tract allows slow emptying of the pouch contents. This pouch empties directly into a limb of intestine which causes the release of gastrointestinal hormones enhancing the feeling of satiety. The longer the limb, the shorter the common channel of small intestine present where the pancreatic enzymes and bile salts can mix with the food to allow absorption. A 100 cm limb appears to work well. It prevents any reflux into the esophagus and allows for adequate absorption of the small amount of food ingested. If a longer segment is used, mild fat malabsorpion can be caused to enhance weight loss. Dumping syndrome which consists of crampy pains, sweating and heart palpitations may be produced when one drinks a high caloric liquid (i.e. milk shake, coca cola) and this acts as a negative reinforcement for undesired habits.

Questions can be directed to Dr. Greenbaum at (609) 877-1737, fax (609) 877-1589
http://www.drthin.com or click here to request additional information.