In
general surgery, a Roux-en-Y anastomosis, or Roux-en-Y, is an end-to-side
surgical anastomosis of
bowel
The gastrointestinal tract (GI tract, digestive tract, alimentary canal) is the tract or passageway of the digestive system that leads from the mouth to the anus. The GI tract contains all the major organs of the digestive system, in humans and ...
used to reconstruct the
gastrointestinal tract. Typically, it is between
stomach
The stomach is a muscular, hollow organ in the gastrointestinal tract of humans and many other animals, including several invertebrates. The stomach has a dilated structure and functions as a vital organ in the digestive system. The stomach i ...
and small bowel that is
distal (or further down the
gastrointestinal tract) from the cut end.
[Roux operation. whonamedit.com]
http://www.whonamedit.com/synd.cfm/3724.html
Accessed on: February 7, 2008.
Overview
The name is derived from the
surgeon who first described it (
César Roux)
[ and the stick-figure representation. Diagrammatically, the Roux-en-Y anastomosis looks a little like the ]letter
Letter, letters, or literature may refer to:
Characters typeface
* Letter (alphabet), a character representing one or more of the sounds used in speech; any of the symbols of an alphabet.
* Letterform, the graphic form of a letter of the alphabe ...
Y.
Typically, the two upper limbs of the Y represent (1) the proximal segment of stomach and the distal small bowel it joins with and (2) the blind end that is surgically divided off, and the lower part of the Y is formed by the distal small bowel beyond the anastomosis.
Roux-en-Ys are used in several operations and collectively called Roux operations.[
When describing the surgery, the ''Roux limb'' is the efferent or antegrade limb that serves as the primary recipient of food after the surgery, while the '']hepatobiliary
The biliary tract, (biliary tree or biliary system) refers to the liver, gallbladder and bile ducts, and how they work together to make, store and secrete bile. Bile consists of water, electrolytes, bile acids, cholesterol, phospholipids and ...
'' or afferent limb that anastomoses with the biliary system serves as the recipient for biliary secretions, which then travel through the excluded small bowel to the distal anastomosis at the mid jejunum to aid digestion. The altered anatomy can contribute to indigestion following surgery.iron-deficiency anemia
Iron-deficiency anemia is anemia caused by a lack of iron. Anemia is defined as a decrease in the number of red blood cells or the amount of hemoglobin in the blood. When onset is slow, symptoms are often vague such as feeling tired, weak, shor ...
. Iron-deficiency anemia develops in up to 45% of people who have had a Roux-en-Y anastomosis.
Operations that make use of a Roux-en-Y
* Some gastric bypasses for obesity
Obesity is a medical condition, sometimes considered a disease, in which excess body fat has accumulated to such an extent that it may negatively affect health. People are classified as obese when their body mass index (BMI)—a person's ...
.
* Multiple failed nissen fundoplication
A Nissen fundoplication, or laparoscopic Nissen fundoplication when performed via laparoscopic surgery, is a surgical procedure to treat gastroesophageal reflux disease (GERD) and hiatal hernia. In GERD, it is usually performed when medical thera ...
surgeries.
* Roux-en-Y reconstruction following partial or complete gastrectomy
A gastrectomy is a partial or total surgical removal of the stomach.
Indications
Gastrectomies are performed to treat stomach cancer and perforations of the stomach wall.
In severe duodenal ulcers it may be necessary to remove the lower port ...
for stomach cancer.
* Roux-en-Y hepatico jejuno stomy used to treat (macroscopic) bile duct obstruction which may arise due to:
** a common bile duct
The common bile duct, sometimes abbreviated as CBD, is a duct in the gastrointestinal tract of organisms that have a gallbladder. It is formed by the confluence of the common hepatic duct and cystic duct and terminates by uniting with pancrea ...
tumour or hepatic duct
The common hepatic duct is the first part of the biliary tract. It joins the cystic duct coming from the gallbladder to form the common bile duct.
Structure
The common hepatic duct is the first part of the biliary tract. It is formed by the ...
tumour
A neoplasm () is a type of abnormal and excessive growth of tissue. The process that occurs to form or produce a neoplasm is called neoplasia. The growth of a neoplasm is uncoordinated with that of the normal surrounding tissue, and persists ...
(e.g. resection of cholangiocarcinoma)
** a bile duct injury (e.g. cholecystectomy, iatrogenic
Iatrogenesis is the causation of a disease, a harmful complication, or other ill effect by any medical activity, including diagnosis, intervention, error, or negligence. "Iatrogenic", ''Merriam-Webster.com'', Merriam-Webster, Inc., accessed 27 ...
, trauma
Trauma most often refers to:
* Major trauma, in physical medicine, severe physical injury caused by an external source
* Psychological trauma, a type of damage to the psyche that occurs as a result of a severely distressing event
*Traumatic i ...
)
** an infection/inflammation (e.g. pancreatic pseudocyst)
* Roux-en-Y choledochojejunostomy – indications same as ''Roux-en-Y hepaticojejunostomy''.
* Roux-en-Y pancreas transplant
* Roux-en-Y pancreas reconstruction after blunt abdominal trauma.
* Roux-en-Y hepaticojejunostomy or choledochojejunostomy with gastrojejunostomy as palliation for irresectable pancreatic head cancer.
References
External links
Anastomoses
– thefreedictionary.com.
{{Digestive system procedures
Digestive system surgery
General surgery
Stomach