Roux en Y Identification
Roux-en-y gastric bypass surgery gets its name from the shape formed by the surgery, a Y shape. With this type of surgery, most of the stomach is disconnected from the esophagus, leaving only a small pouch behind to hold food. This causes patients to feel full after eating small amounts of food. The other part of the surgery involves connecting this small stomach pouch to the duodenum, which is the middle part of the small intestine. By bypassing the first portion of the small intestine, the surgery limits how much food can be absorbed by the intestines, which further lowers caloric absorption.
Roux-en-y Reversal
Because all of the stomach and intestine are left in the body after roux-en-y gastric bypass surgery, reversing the operation primarily entails reconnecting the stomach and small intestines. This means that the small stomach pouch must be disconnected from the duodenum and reconnected to the rest of the stomach. The main part of the stomach (which had been disconnected from the esophagus) still has its connection to the beginning of the small intestine. To do this, the surgeon cuts the small stomach pouch away from the duodenum, leaving as much tissue intact as possible, and then either sutures or staples it back in place with the rest of the stomach. The hole in the duodenum (where the pouch had been attached) also has to be sutured closed to prevent digestive enzymes from leaking throughout the abdomen.
Reasons for Reversal and Possible Complications
There are many reasons why roux-en-y surgery could need to be reversed. The patient could reach his or her weight-loss goals and no longer need the altered digestive tract. In the case of a female patient, she may wish to become pregnant, and, as a result, need to lift the dietary and nutritional limits that such operations provide. Sometimes gastric bypass surgery can leave a patient malnourished. Finally, in some cases the original roux-en-y surgery is not successful and results in internal bleeding, in which case the surgery needs to be reversed to prevent further damage. Internal bleeding is a risk with the reversal procedure as well, in addition to bacterial infection of the surgical site and damage to the tissues of the digestive system.
