Roux-en-Y anastomosis

I think we've seen a kind of a paradigm shift in when and where massive weight loss comes from.

I think traditionally, you know, diet and exercise, if it's not enough, what do you go to? You know, previously it was a duodenal switch and now it's more recently the gastric sleeve and Roux-en-Y bypass.

And that's where you had patients who lost tons and tons of weight.

And these were big surgeries.

And so despite having surgery to kind of correct this problem of basically, you know, overeating, you know, they would

work through it and it wouldn't really have a long lasting effect.

On the other hand, you saw great success stories with, you know, Roux-en-Y patients and huge weight losses.

And that comes with,

And this is what we are using more nowadays So what's the bariatrics? So that's the surgical bariatric just means the surgery options.

Okay, so we got Roux-en-Y.

We've got biliopancreatic switch.

I think that's like the preferred one nowadays.

Surgery for weight loss has been around for decades.

I would say that the most common surgeries these days is either the laparoscopic sleeve gastrectomy or the Roux-en-Y gastric bypass, which is also a laparoscopic surgery.

Those are probably the two most commonly done surgeries in the country.

And then for specific types of patients, we have other surgeries that can be offered as well.

So yeah, but you do worry about these people and whether they're getting the right type of information, whether they're disclosing the information.

Things like eating disorders, I mean, unless you ask or unless you have some type of way to screen for it, no one's going to necessarily disclose that.

There are two main options for bariatric surgery, the laparoscopic sleeve gastrectomy and the Roux-en-Y gastric bypass.

Both surgeries change the size of the stomach, which reduces the volume of food you're able to consume.

bypass? I

did, like a Roux-en-Y years ago.

And because I was like, willpower was not enough.

I even, I was like, changers don't have the cookies in the house, which yes, is changing the situation.

anyway

so there's operable and then we're mainly dealing with patients who are inoperable because if you're operable you should go for a you know a curative resection get rid of that cancer as best you go if that's what they're going to do and the surgeons will do some form of bypass procedure as part of that so whipples or gastrectomy or whatever they're doing for these kind of cancers there's always at some point where they're having to reconstitute their intestinal flow so they've got to anastomose something to something I mean in Whipple's it's three different things things like distal gastric cancer you basically end up with a gastrogeogenosomy or sometimes a Roux-en-Y but they'll crack on with that We're talking about patients who, for whatever reason, can't have an operation.

Okay.

And so, you know, what are the options? Well, there are several, aren't there? So everything down from enteral stenting, which is what's been a common go-to thing, and it works reasonably well, although we can talk about the durability of that.

Hey, Lady Prepper.

I had a Roux-en-Y bypass 19 years ago.

Should I take ox bile with carnivore? High fat makes me sick sometimes.

So you might need ox bile, an ox bile supplement for a month or two as your body gets used to carnivore.

I think you can keep losing weight up to 12 to 18 months, but it slows down.

I mean, the first couple months, it's a pound a day easy, pound, pound and a half a day, and you're going, what the hell? For those that don't know, I had bariatric sleeve surgery, not the Roux-en-Y, which Handel had 25 years ago.

That's the Cadillac.

That's when they not only... you know, they shrink all the size of the streets, they tie them in a knot.