The traditional RYGB surgical approach begins with fashioning a small gastric pouch
using the gastric fundus, leaving the larger excluded stomach intact.
Another 6-month follow-up study that enrolled 45 patients showed a reduction in BMI of 5.8 kg/m 2 and a %EWL of 49.4%. A prospective multicenter trial showed that POSE was also effective in reducing a dilated gastrojejunal (GJ) anastomosis and shortening the gastric pouch
in patients. POSE needs to be done under general anesthesia and is still under FDA review for approval.
The RYGB involves the creation of a 30-mL proximal gastric pouch
that is anastomosed directly to the proximal jejunum, thus bypassing the greater portion of the stomach and duodenum.
Also, we used a hanging suture between the gastric pouch
and the afferent loop to minimize reflux and a retaining suture between the lower part of the pouch and the antrum to prevent it from twisting.
Intraluminal pressure has been cited as a factor that may lead to increased leaks from the staple line, a logical contention and one that is supported by measurements of higher intraluminal gastric pressure within a sleeve than within a gastric pouch
following roux-en-y gastric bypass [24,25].
During the surgery, a 30 ml gastric pouch
is created; then the small bowel is divided 30-40 cm from the ligament of Trietz to create the biliary limb and Roux limb.
This is achieved by increasing the size of the gastric pouch
, compared to gastric bypass, and by allowA[degrees] ing the pouch to drain into the intestine freely (compared to sleeve gastrectomy).
In YGBP group, the dissection began directly on the lesser curvature of the stomach, and a gastric pouch
of about 20% of the total gastric volume was created.
However, due to the small gastric pouch
, voluminous emesis is rarely encountered .
The parietal cell mass within the small gastric pouch
that is left attached to the oesophagus, the complete elimination of duodeno-gastric reflux owing to a long Roux limb, and decrease in intra-abdominal pressure with weight loss all contribute to an almost total reflux control in all patients.
In Village Location Guide Price pounds 95,000 "The gastric bypass would help to provide better control for cravings for sweet foods and, as it involves the creation of a small gastric pouch
and by bypassing a portion of the upper small intestine, it effectively reduces the absorption of calories.
The whole area was scarred and thickened, so when we were building the gastric pouch
, we used the stapler with green cartridges.