Procedure of the operation
The operation is performed under general anesthesia. To prevent large scars, the operation is usually performed laparoscopically. This means that surgical instruments and a camera are inserted through several skin incisions that are only a few centimeters short.
In addition, air is injected into the abdominal cavity during the operation so that the abdomen is inflated, making it easier for the surgeon to work. In gastric bypass, the esophagus is first separated from the rest of the digestive tract shortly after entering the stomach, so that a very small part of the stomach is still preserved. The rest of the stomach is sutured up tightly.
The esophagus and the small remainder of the stomach are connected to the small intestine. For this purpose, the small intestine is divided about half a meter after its beginning at the stomach exit. The lower small intestine is pulled up and connected to the small stomach.
In this way, the normal food passage with bypassing the stomach is restored. The rest of the stomach remains in the body and continues to produce stomach acid and hormones. The small intestine, which is connected to the stomach but separated from the rest of the digestive tract, is sewn laterally to the small intestine further down.
This is important so that the digestive juices from the pancreas and the bile can reach the food pulp. These are released into the intestine shortly after the stomach exit. The intestinal loops then form a kind of Y.
This is why the operation is called Rough-Y stomach bypass. The connection between the remaining stomach and the small intestine must be checked by the surgeon to ensure that it is tight. He also has to make sure that there is no tension on the connections (in technical jargon this is called anastomosis), as this prevents the suture from healing.
Finally, the instruments are removed and the small skin stitches are closed. The duration of the procedure is about 3 to 4 hours.In individual cases, the procedure can also be extended quickly. After previous operations, adhesions often occur in the abdomen.
The release of such adhesions can be very time-consuming. Complications such as bleeding or injury to other abdominal structures also prolong the operation. After a gastric bypass operation, the patient must remain in hospital for about 5 days to rule out possible postoperative complications, such as inflammation in the abdomen. In case of postoperative complications, unforeseen events in the operating room or the existence of other diseases, the hospital stay can also be prolonged significantly.
