Mar 26, 2015 4:31 PM Exclusive: What exactly is a gastric bypass?


WARNING: The video above contains some graphic images.

Weight loss surgeries have been performed safely and effectively for years to help the morbidly obese to lose weight.

The gastric bypass, or roux en-y surgery has been the most effective in accomplishing significant weight loss. It does this by surgically first cutting the stomach into smaller gastric pouch. Next the small intestine is divided and reattached bypassing a large amount of the small intestine. This decreases the size of the digestive tract, restricting the amount of food that can be ingested. This gives patients a feeling of early fullness, leading to significant weight loss.

Robotic gastric bypass surgery is a new technologically advanced minimally invasive technique that's only being done at few centers nationwide. Why the robot? The robotic image features a 3D high definition system for better visualization. Unlike traditional laprascopic surgery, the robotic system has special wristed instruments that bend and rotate far greater than the human wrist.

The first part of the surgery is the creation of smaller stomach called the "gastric pouch." The stomach is divided in two to three places, freeing it from the remainder of the stomach resulting in a smaller gastric pouch. This pouch is significantly smaller than that old stomach and you can see that on the left side. This restricts the amount of food intake to an area close to the size of a walnut. The remaining stomach that will be bypassed is on the right side of the screen. Now we have a gastic pouch as shown here.

Next, a section of the small intestine, the jejunum, is brought up the gastric pouch. The muscle layers of the gastric pouch and the jejunum are sewn together to ensure the connection is strong. While you are watching these two layers being sewn together, you can appreciate the range of motion of the instruments, acting like small hands as the surgeon uses them to perform delicate technique. These instruments are one of the advantages to doing this procedure using the robot.

A hole is cut and cauterized into the stomach.

Next a hole is cut and cauterized into the jejunum.

These holes will be attached together to connect to the gastric pouch to the small intestine. The robot allows this connection to be sewn together compared to traditional laparoscopic gastric bypass where the connection is stapled together. This is called the gastrojenunostomy and is the connection that allows food to travel from the gastric pouch to the small intestine to be digested.

Next another section of small intestine is stapled and released from the gastrojejunostomy in preparation for the final connections.

The final two sections of the small intestine are stapled together. This is called the jejunojejunostomy.

This done by first making holes in each section of the small intestine.

Then the stapler is placed inside the two sections to staple them together and make the final anastemosis. This last connection allows gastric juices to flow from the bypassed stomach to the new tract allowing food to be digested appropriately.

All of the connections are checked for leaks, and then the surgery is done.

With a doctor supervised diet and exercise plans, this patient is on their way to a new healthier life.


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