Retrocolic Roux-en-Y gastric bypass

The Roux-en-Y retrocolic gastric bypass configuration is characterized by a small (less than 30 mL) proximal gastric pouch divided and separated from the stomach remnant, with drainage of food to the rest of the gastrointestinal tract via a small gastrojejunal anastomosis and a Roux-en-Y small bowel arrangement. The small intestine is divided at a distance of 30 to 50 cm distal to the ligament of Treitz, and a proximal biliopancreatic limb is created to transport the secretions from the gastric remnant, liver, and pancreas. The Roux limb (or alimentary limb) is anastomosed to the new gastric pouch and functions to drain consumed food. The cut ends of the biliopancreatic limb and the Roux limb are then connected 75 to 150 cm distally from the gastrojejunostomy.