The first surgery used widely for obesity was called intestinal bypass, which involved heavy-duty surgery in which part of the absorptive area of the intestine was bypassed. This was done in the 1970s and 1980s, and while people lost weight, the side effects and complications were substantial. The initial concept was to use a surgical procedure which provoked a short bowel syndrome- (jejunoileal bypass) which is the clinical situation with most weight loss. However, the dramatic metabolic consequences indicated the necessity to develop less aggressive, but still efficient, surgical procedures to bring about a loss of weight. The different approaches that have been developed during the years aimed to minimize the operative trauma and optimize the long term nutritional and metabolic consequences. As a result, procedures such as vertical banded gastroplasty and gastric banding were introduced into clinical practice. These procedures were associated with a limited weight loss but, importantly, there were undesirable chronic side effects and complications also occurred. For these reasons, other techniques have been developed including mixed restrictive and low malabsorptive procedures such as the Roux Y gastric bypass.
HOW?
Gastric bypass consist of a combination of operations. They combine both restrictive and malabsorptive techniques:
Create a small stomach pouch to restrict the amount of food you can eat.
Construct a bypass of the duodenum and other parts of the small intestine to cause malabsorption. There are two types of gastric bypass procedures:
Roux-en-Y Gastric Bypass (RGB)
This is the most common bariatric procedure. First, the surgeon creates a small stomach pouch with staples or a vertical band. This restricts food intake. Then he attaches a Y-shaped section of the small intestine to the pouch to allow food to bypass the first and second segments of the small intestine. This reduces patient’s body's ability to absorb nutrients and calories................
