Friday, July 29, 2011

And That's the way It was Friday July 29th, Goodnight

So can anyone tell me who use to sign off the air like this? Well here it is Friday once again. People all over America off for the weekend. They will spend money they can't afford, do things they should not do and regret it all Monday morning, or they will spend time with family and God, be rested and ready to go Monday. Which sounds better to you?

So today I said I would talk about the second surgery. Please, Please know that this information I have gotten and in no way should be considered an expert opionion! The Gastric Bypass or also known as the Roux-en-Y :

Step One, Gastric Bypass Procedure: Divide Stomach and Jejunum

During the gastric bypass procedure, the upper stomach is divided with a stapler and reinforced with stitches to create the new upper (proximal) stomach pouch. The new pouch is the size of a golf ball, holding about 20 cc. The pouch is made so small for two reasons. First, it will eventually stretch somewhat. By making it very small at first, the final size will still be quite restrictive. Second, the upper pouch continues to make stomach acid. The pouch is kept small to minimize the amount of acid that enters the upper jejunum and thus minimithe chance of developing an ulcer at the stomach jejunum anastamosis.

The lower (distal) larger part of the stomach is left in place for three reasons. First, it still produces acid and pepsin to help digest food. These juices travel down the duodenum and into the jejunum to mix with food. Second, if for any reason a patient needs to have the operation reversed, the stomach is still there and can be hooked up again. Please note that this is very rarely necessary. Third, removing the lower part of the stomach would greatly prolong the surgery and make it more dangerous.
The upper jejunum is also divided in preparation for bringing it up to connect to the upper stomach pouch.







Step Two, Gastric Bypass Procedure: Attach Jejunum to Stomach Pouch

The part of the jejunum that is brought up behind the colon and lower stomach pouch is called the "Roux limb". (Roux was a Swiss surgeon who developed the general technique.) The Roux limb is joined or "anastamosed" to the upper stomach pouch using a circular stapler or with a hand sewn technique. The staple line is reinforced where necessary with hand sewn stitches. The opening between the pouch and the intestine is 1.1cm (less than 1/2 inch) in diameter.

Step Three, Gastric Bypass Procedure: Attach Proximal Jejunum to the side of Roux Limb

The end of the jejunum is attached to the side of the Roux limb. Thus, food goes down the esophagus into the upper pouch. It then goes through the anastamosis into the Roux limb. Digestive juices from the stomach, the liver, and the pancreas travel down the duodenum and jejunum and are added to the food that has come down the Roux limb where the two parts of the small intestine are attached. The food and the juices then travel down the small intestine mixed together and further digestion takes place.

Step Four, Gastric Bypass Procedure: Gastrostomy Tube

A gastrostomy tube is occasionally inserted through the left upper abdominal wall into the lower stomach. The tube is a safety device that allows stomach juices to escape if the juices can't drain easily into the small intestine. Most patients don't need the tube, and the decision to place the tube is made at the time of surgery based on how loose or tight the tissues are where the small bowel is attached to the Roux limb. The gastrostomy can cause complications, and it is inconvenient and uncomfortable, so we do not use it routinely. If a gastrostomy tube is inserted, it can easily be removed in the office about 3 weeks after surgery.

So here is the address to this information site. Because I do not know a lot on this subject I felt better doing it this way. There are Diagrams to go with the steps on this site.

Stress Reducers:
Deep Breathing

Words of Wisdom:
I use to complain about my shoes until I met a man with no feet!

May The Lord Continue To Bless You All!


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