Roux en-Y Gastric Bypass, with Introduction on Body Mass Index, Animation.

Bariatric surgery, or weight loss surgery,
refers to a variety of surgical procedures for treatment of morbid obesity. Obesity is
determined by Body Mass Index or BMI, which is calculated as the ratio of body weight
over square of body height. The higher the BMI the higher the extent of obesity. A normal
BMI is between 20 and 25. An individual is considered morbidly obese if he or she has
a body mass index of 40 or more, or of 35 or more if he or she also has obesity-related
health problems such as diabetes, sleep apnea or hypertension. Weight loss is achieved by
reducing the size of the stomach. Smaller stomach makes the patient feel full faster
and therefore makes it easier to reduce the amount of food intake.
Roux en-Y Gastric bypass This is the most commonly performed bariatric
surgical procedure and is considered the gold standard for weight loss treatment. This procedure
involves two steps: – Step 1: the stomach is divided into two
parts : one small pouch at the top of the stomach where it is connected to the esophagus
, and the rest of the stomach which will be bypassed. The two parts are separated and
stapled. – Step 2: Rerouting of the intestine: the
intestine is cut at about 45cm or 18in down from the end of the stomach. The first part
of the intestine – the duodenum – will be bypassed. The top end of the second part – the
jejunum – is pulled up and connected to the gastric pouch created in step 1. The lower
end of the duodenum is reconnected to the jejunum at a lower point. The new configuration
has a shape of an Y, hence the name of the procedure.
How weight loss is achieved? Firstly, the volume of the stomach is now
greatly reduced to a small pouch, usually less than 10% of the original volume, which
is filled up fast after a small amount of food intake. This sends a signal to the brain
that the stomach is full and generates a feeling of fullness or satiety. This helps to reduce
the amount of food intake. Secondly, as the first part of the intestine – the duodenum
– is bypassed, the amount of nutrition absorbed by the body is greatly reduced. In normal
digestion, this is where most of the nutrition is absorbed. Malabsorption contributes to
weight loss effect. Complications
While this procedure is proven as an efficient long term weight loss treatment, it associates
with significant complication risks. These include: leakage along the staple lines and
surgical connections leading to infection and abscess formation; stricture and obstruction
of the digestive tract due to scar formation; dumping syndrome; nutritional deficiencies;
and other general surgical risks due to the complexity of the procedure.

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