Johnson & Johnson Institute
Laparoscopic Roux-en-Y gastric bypass
Procedure overview
Gastric bypass, also called Roux-en-Y gastric bypass (RNY), is a type of weight-loss surgery that involves creating a small pouch from the stomach and the creation of a roux limb. The roux limb is anastomosed to the gastric pouch and a second anastomosis connects the biliopancreatic limb to the roux limb. After gastric bypass, swallowed food will go into this small pouch of stomach and then directly into the roux limb thereby bypassing the excluded stomach and the first section of the small intestine.
With RNY gastric bypass, there is a great deal of variability in the steps of the procedure. Surgeons may start with pouch creation or roux limb creation. Likewise, there is a great variability in measurements of the pouch, bilio-pancreatic limb, and roux limb. Techniques for anastomoses and pouch creation also vary widely.
Indications & objectives
Gastric bypass is utilized as a treatment for the disease of obesity and its associated medical conditions. According to the ASMBS (American Society of Metabolic and Bariatric Surgery) guidelines for bariatric surgery, the indications for weight loss surgery are as follows:
- BMI equal to or greater than 35
- BMI 30 to 34.9 with one or more related comorbidity including, but not limited to, type 2 diabetes, hypertension, sleep apnea and others
- BMI 30 to 34.9 with metabolic syndrome or type 2 diabetes
References
VISTASEAL™ Fibrin Sealant (Human) IMPORTANT SAFETY INFORMATION
INDICATION
VISTASEAL™, a fibrin sealant, is indicated as an adjunct to hemostasis for mild to moderate bleeding in patients undergoing surgery when control of bleeding by standard surgical techniques (such as suture, ligature, and cautery) is ineffective or impractical. VISTASEAL™ is effective in heparinized patients.
CONTRAINDICATIONS
Do not inject directly into the circulatory system.
Do not use for the treatment of severe or brisk arterial bleeding.
Do not use in patients with history of anaphylaxis or severe systemic reactions to human blood products.
Do not use VISTASEAL™ for spraying unless the minimum recommended distance from the applicator tip to the bleeding site can be achieved.
WARNINGS AND PRECAUTIONS
Thromboembolic events may occur if VISTASEAL™ is administered intravascularly.
Hypersensitivity reactions can occur.
May carry a risk of transmitting infectious agents, e.g., viruses, the variant Creutzfeldt-Jakob disease (vCJD) agent and, theoretically, the Creutzfeldt-Jakob disease (CJD) agent.
ADVERSE REACTIONS
The most common adverse reactions (reported in >1% of patients) were procedural pain, and nausea.
For complete indications, contraindications, warnings, precautions, and adverse reactions, please reference full package insert.
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© Johnson & Johnson and its affiliates 2024
For complete indications, contraindications, warnings, precautions, and adverse reactions, please reference full package insert.
Christopher Joe Northup, MD prepared this procedure guide on behalf of Johnson & Johnson and its affiliates. The procedure guide reflects the opinions of the individual presenter, and the steps described may not encompass the complete steps of the procedure. Additionally, other surgeons may prefer different techniques, approaches, etc., as individual surgeon experience in his/her clinical practice, as well as patient needs, may dictate variation in procedure steps.
Before using any medical device, review all labeling, including without limitation; the Instructions For Use (IFU), and relevant package inserts with particular attention to the indications, contraindications, warnings and precautions, and steps for use of the device(s).
This presentation is not accredited for CE/CME.
Christopher Joe Northup, MD is compensated by and presenting on behalf of Johnson & Johnson and its affiliates and must present information in accordance with applicable regulatory requirements.
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