The divided gastric bypass with Roux-en-Y gastro-jejunostomy consists of separating the stomach into two sections using parallel rows of titanium staples, with many of the staples additionally over-sewn or secured with sutures as needed. The staples remain fixed and do not migrate. The small upper segment connected to the esophagus remains the food-functional portion of the stomach, while the large lower segment connected to the duodenum, though still functional, does not deal with food eaten by the patient.
In the next phase, the surgeon disconnects the continuity of the small intestine (upper jejunum) and brings the lower end up to the small gastric pouch still connected with the esophagus. This section of the intestine is still functional. The intestine is connected to this small stomach pouch by means of an opening about the size of a dime. This allows food to pass directly into the intestine where it is digested. This is called a gastro-jejunostomy
When the small functioning upper stomach pouch is full (at first this will occur with only a nibble or two), patients experience a sense of fullness. In this way, and because the appetite will also be reduced, the intake of food is dramatically limited. This is what enables weight loss. What food is eaten is handled by the body quite well.
On average, patients will lose about 100 lbs. or up to two thirds of their excess weight in one year. Some people lose a little more, some a little less. Weight loss will continue during the second year at a less rapid rate.
As with any surgery, these procedures carry risks and possible side effects, but the amount of weight loss can be significant and dramatic.
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