Roux-en-Y Gastric Bypass (RYGB): Gold Standard of Metabolic Surgeries

Among the 1st in India: RYGB from 2002

Largest volume of RYGB in Tamil Nadu

2hr : 00min



How does an RYGB work

Roux-en-Y Gastric bypass is a surgery done to help reduce weight and fight diabetes. In this procedure the very top part of the stomach is cut and reduced to the size of an egg. The middle portion of the small intestine is then cut and pulled up, attaching one end to the small egg sized stomach.

The reaming larger stomach is still attached to the upper portion of the small intestine. This tub is then stitched into place with the remaining intestine, joining the middle portion of the intestine that is now part of the smaller stomach.

This cause the intestine to take on a ‘Y’ shaped structure, hence the name Roux-en-Y Gastric bypass.

How is an RYGB Performed

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    1 to 4 tiny incisions (1 for scarless surgery; 4 for regular laparoscopic surgery) are made in abdomen through which the surgeon accesses the stomach

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    Energy devices are used to demobilize the stomach and make it free to manipulate

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    Stomach Stapling

    Using devices called laparoscopic staplers, the surgeon cuts the stomach near the upper end. While cutting the stomach, the stapler also seals the cut ends of the stomach. The cut is made in such a way that the upper stomach is a little larger than an egg.

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    Rerouting the small intestine

    Leaving about first 60cm of the small intestine still attached to the stomach lower stomach, the rest is rerouted and attached to the newly formed upper stomach. This arm of the intestine now carries all the food the patient eats.

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    Forming the Y

    Remember a 60cm bit of small intestine was left hanging from the lower end of the stomach? Well, the surgeon takes the free end of this stub and attaches it to the later part of the small intestine that carries the food.

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    Finishing Up

    The surgical team performs a quality check and retracts and closes up.

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    The patient is typically requested to remain in the hospital for 2 to 3 days after the surgery. After whih time, they are discchared from the hospital, with a request to take 5 more days of bed rest at home

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    5 Yr Free follow up

    All patients who undertake bariatric surgery at LIMA have five years of free support in terms of free consultation, patient education, bariatric community, life change coaching, etc.

Roux-en-Y is considered the gold standard for bariatric weight-loss (or metabolic) surgeries.

This surgery results in decreasing the size of the stomach, thereby decreasing the patient’s appetite. Also, after RYGB, food bypasses the first section of the small intestine (duodenum), thereby avoiding absorption of calories. Through these two mechanisms alone, the patient’s excess body weight normalizes within 6 to 12 months from the surgery.

But that’s not all.

Because of the hormonal changes brought about after a Roux-en-Y Gastric Bypass, in a matter of two weeks to two months after this procedure, the diabetic status of the patient reverses too.

Limitations of RYGB

There are two limitations with Roux-en-Y Gastric Bypass:

  • This is a rather complicated surgery. Not many surgeons are trained to carry out this surgery flawlessly.
  • People who undergo this surgery are required to take vitamin and mineral supplements throughout their life. Though these are very inexpensive, some people find it a mild nuisance.

Video: Performing Roux-en-Y Gastric Bypass




gastric bypass specialist

Dr. J.S Rajkumar

Chief Surgeon

M.S., F.I.C.S., Dip. N.B. (SURG.), F.R.C.S. (ENG.), F.R.C.S. (EDIN.), F.R.C.S. (GLASGOW), F.R.C.S. (IRELAND), F.I.M.S., F.A.I.S., F.R.M.S. (LONDON), F.A.E. (GASTRO), F.A.C.G. (USA), F.I.C.A. (USA), F.I.A.G.E.S., Dip M.I.S. (FR.)

Dr. Anirudh Rajkumar

Bariatric and Laparoscopic Surgeon