Roux-Y Gastric Bypass (RYGB) Description of Surgery: The RYGB combines both restrictive as well as malabsorptive techniques to improve weight loss. The stomach is made smaller by creating a small pouch with surgical staples that holds about 1-2 ounces (the size of an egg). The smaller stomach is then attached to the middle section of the small intestine bypassing the first portion of intestinal tract. This procedure can be done using small incisions in the abdomen (laparoscopic technique) or by creating a large incision in the abdomen (open technique). Things to Think About: Only small portions of food can be consumed. Concentrated sugars must be avoided due to “dumping syndrome”. Life-long B-12 supplementation (by injection every month or daily by pill). Because the part of the intestine that absorbs minerals and vitamins is bypassed patients may have iron, calcium, magnesium, and vitamin deficiencies. Gastric bypass is irreversible Results: Weight loss varies in individual patients but weight loss is generally excellent (50%-70% of excess weight). Peak weight loss typically occurs between 12 and 18 months. Very good long-term results > 20 years. Greater than 87% long-term patient satisfaction.