LAPAROSCOPIC ROUX-EN-Y GASTRIC BYPASS (RNY)
The RNY is one of the most commonly performed bariatric surgeries in the US and the world. It involves the complete transection of the stomach, creating a small, new pouch, which is connected to the small bowel through a small orifice. Almost the entire stomach, the duodenum, and about 5 to 6 feet of the small bowel are bypassed (see diagram). This is a strong metabolic operation, which is excellent for patients with diabetes and abnormal lipids. The RNY does produce malabsorption of certain nutrients, such as iron, vitamin B12, folate, and calcium. Without proper supplementation, these nutrients may become deficient. With new technological advances and extensive surgeon experience, this procedure is safe and is associated with a minimal amount of complications. The RNY takes about 1 hour to perform and requires 24 to 48-hour hospital stay.
The RNY may cure or significantly improve GERD, diabetes, hypertension, high cholesterol, obstructive sleep apnea, high triglycerides, infertility, PCOS, fatty liver, and pseudotumor cerebri. It is the procedure of choice for patients with diabetes.