Laparoscopic Gastric bypass is considered the gold standard of weight loss surgeries. This is because we have most available data on this procedure with good results long-term and an excellent risk benefit ratio in properly selected patients.

Gastric bypass is one of the most common weight loss procedures today.

The stomach is stapled and divided into two portions right below its junction with the esophagus. The smaller stomach/ gastric pouch is attached to the esophagus and the much larger remaining portion of the stomach is bypassed. Then the intestine is divided about 18 inches below the stomach and the bottom portion of the divided intestine is brought up and attached to the gastric pouch. The top portion of the intestine at the division is reattached to the intestine about five feet beyond the division as seen in the picture.

Essentially the previous straight path of intestine is changed to a Y configuration. Food entering the esophagus enters into the gastric pouch and then directly into the attached intestine. Food does not enter into the main stomach anymore. The stomach enzymes as well as bile and pancreatic enzymes enter the bypassed portion of the intestine and come down to meet the food pathway where the two intestines meet. Please see the following two videos that illustrate the Gastric bypass.

The capacity of the new stomach/ gastric pouch is 15cc or Half ounce. The opening between the pouch and the intestine is deliberately made tight, 12mm in size (the size of a regular Tylenol tablet). Therefore you can eat a very small portion of food early on after the surgery. However few months later most patients can eat a small child size portion and are satisfied with it.