Malabsorptive (Medial) Gastric Bypass

Stomach-restrictive surgery with significant malabsorption.

The malabsorptive (medial) roux-en-y gastric bypass is a stomach-restrictive operation with significant malabsorption. A small stomach pouch is created, very similar to the one created with the proximal gastric bypass. This operation is different than the proximal gastric bypass in that roughly two-thirds to three-fourths of the small intestine length is bypassed, resulting in a significant decrease in calorie absorption. Weight loss is achieved both through restriction of food consumption as well as malabsorption.

How It Works

For this operation, the surgeon creates a small stomach pouch (approximately 15 ml) which restricts the amount of food that can be consumed. Patients usually report feeling full after eating about 2 ounces of solid food. The small intestines are then divided and the lower section is attached directly to the small stomach pouch. The food you consume travels through this portion of the small intestines undigested until it meets with the top portion of intestines carrying digestive juices (bile and pancreatic juices). This section is referred to as the bilio-pancreatic limb or BPL (which is long in this type of operation) and is connected 60-80 inches (5-7 feet) from the large intestine (colon). This last one-third to three-fourths of the total small intestinal length where the food stream and intestinal juices mix together is where absorption occurs and is called the common channel (CC). Absorption of nutrients and calories is determined by the common channel length, so a short common channel decreases the risk for weight regain by decreasing calorie absorption.


  • About 80% excess weight loss (EWL) has been reported. (10) (Excess weight is the amount of weight over what is considered the “ideal body weight” for a person’s height [Current Weight – Ideal Weight = Excess Weight]. The percentage of excess weight loss (%EWL) is the percentage of weight loss from this excess weight.)
  • Improvement/resolution in all major co-morbidities has been documented, including type 2 diabetes, sleep apnea, hypertension, high cholesterol and depression.
  • Because weight loss is achieved through stomach restriction as well as malabsorption, this surgery is a great option for patients with a high BMI.
  • This operation typically provides very predictable weight loss with great long-term weight loss success.

Michelle, Malabsorptive (Medial) Gastric Bypass

Michelle, Malabsorptive (Medial) Gastric Bypass

Read the success story   

At 333 lbs., Michelle was miserable in her 5’2” frame. She had sleep apnea, severe hip and knee pain, and heartburn that “kept the Tums manufacturer in business.” With a grandchild on the way, Michelle knew she needed to take control of her health. Since losing 185 lbs.,** Michelle can now jog on the treadmill, fly comfortably in an airplane and wear clothes from any store she wants!

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