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The Roux-en-Y Procedure
Bariatric Surgery

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The Digestive Anatomy


Step One

The stomach is stapled just below the esophagus, forming a 20 to 30cc (1 ounce) stomach pouch above the staples, severely restricting the amount and kind of food or liquid that can be consumed at one time.

Step Two

The small bowel is divided about one foot below the stomach (points A and B). Then a new 1.5 centimeter opening (stoma) is created in the stomach pouch (Point C).

Step Three

The open end of the small bowel at Point B is attached to the new opening at Point C. Food and fluids can now pass from the stomach pouch into the small bowel. The remaining end of the small bowel (Point A) is attached at Point D, creating a "Y-shaped" intestinal junction. An opening is made at Point D to allow digestive juices from the bypassed part of the stomach to flow into the small bowel.


Adapted from Bray, G.A., Gray, D.S. Obesity, Part I. Pathogenesis. West J. Med. 1988: 149:429-41.
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