Historically the gastric bypass was based on the weight loss observed among patients undergoing partial stomach removal for cancer and peptic ulcer disease. In 1966 Dr Mason, a surgeon from the University of Iowa, described the first gastric bypass, consisted of an horizontal stomach pouch with a loop small bowel configuration (Mason loop). Due to severe bile reflux the initial bypass surgery underwent modification which resulted in the “Roux-en-Y” gastric bypass.

How it Works

Over the years several modifications to the technique was proposed to increase the weight loss and durability of the effect. Modifications to pouch size and limb lengths and using a ring to prevent expansion of the aperture between the stomach and the small bowel loop are most notable.

Currently the most common technique involves the creation of a small 30ml stomach pouch, a biliary limb of 70 cm and a roux limb of 150 cm. An exponential growth of this operation was noted since the adoption of laparoscopic (Key hole access to the abdominal cavity) approach to the gastric bypass in 1994.

Quick Info

  • Currently the most common technique involves the creation of a small 30ml stomach pouch, a biliary limb of 70 cm and a roux limb of 150 cm.

  • A more complex procedure to perform and potentially has a relatively higher complication rate. As a result this operation is not as commonly offered in Australia.

  • In our current practice we reserve this technique for obese subjects with significant gastro oesophageal reflux disease and/or Barrett’s oesophagus.

Roux-En-Y Gastric Bypass

Roux-en-Y Gastric Bypass

Explainer video taking you through the steps of the procedure.

Further Information

REYGB has been the most commonly performed operation for weight loss in the United States and many other parts of the world for many years until the sleeve gastrectomy has taken over in recent years. As an established procedure with an overwhelming body of literature and evidence over 40 years, REYGB continues to be the gold standard of bariatric surgery.

REYGB is technically a more complex procedure to perform and potentially has a relatively higher complication rate. As a result this operation is not as commonly offered in Australia as in many other parts of the world. In our current practice we reserve this technique for obese subjects with significant gastro oesophageal reflux disease and/or Barrett’s oesophagus.

If you have any chance of smoking, need for regular use of erosive medications (mostly anti inflammatory medications), consume alcohol, your chance of developing an ulcer is much higher after a gastric bypass procedure. You also need to follow the dietitian recommendations on diet and be on daily vitamin and mineral supplements for life to reduce the risks of malnutrition and nutritional deficiency.

Obesity facts

  • Low levels of vitamins iron and calcium(if you don’t take supplements daily for the rest of your life)
  • Trouble getting enough protein
  • Ulcer (higher risk if you smoke, drink excessive alcohol or take erosive medications)
  • Gallstones
  • Dumping syndrome (this can cause nausea, fast heartbeat, abdominal cramping, fainting, and diarrhea after eating.)
  • Narrowing of the sites where intestines are joined (stenosis or stricture)
  • Dangerous internal hernia (the small intestine can be trapped and blocked usually demanding emergency surgery to prevent intestinal loss)
  • Need for additional surgery
  • Failure to lose enough weight
  • Weight regain (if you snack on high-calorie foods and don’t exercise)