How does it Work?

• It is both restrictive and malabsorptive procedure
• Stomach is cut to create a small gastric pouch (15-20 ml)
• A segment of small intestine is attached to the new stomach
• The intestine is re-routed so the food bypasses most of it to decrease the absorption of calories
• Operative time: 2 hours
• Hospital stay: 2-3 days
• Return to work: 1-2 weeks

Advantages:

• Rapid initial weight loss. Can lose 70% of excess weight
• Good for high BMI patients > 55 kg/m2 who need quick weight loss
• Higher total average of weight loss than the LAP-BAND and Sleeve gastrectomy
• Theoretically can be reversed but difficult

Disadvantages:

• Requires cutting of the stomach and small bowel
• More operative complications than the LAP-BAND and Sleeve gastrectomy
• Complications due to malabsorption: anemia, osteoporosis, diarrhea, vitamins deficiency
• Higher incidence of gallstones (gallbladder is not stimulated)
• Dumping syndrome when taking carbohydrates
• The remaining part of the stomach is not accessible, can develop an ulcer or tumor
• Can’t access the biliary tree with diagnostic testing if needed
• Higher mortality rate (0.5%)
• Reversing is necessary in some patients due to severe weight loss and malnutrition

Surgical Complications:

• 3% Leaking from stomach cut edge or small bowel connections
• 3% Narrowing of the stoma requiring dilatation or re-operation
• 2% Small bowel obstruction