Roux-en-Y anastomosis


In general surgery, a Roux-en-Y anastomosis, or Roux-en-Y, is an end-to-side surgical anastomosis of bowel used to reconstruct the gastrointestinal tract. Typically, it is between stomach and small bowel that is distal from the cut end.

Overview

The name is derived from the surgeon who first described it and the stick-figure representation. Diagrammatically, the Roux-en-Y anastomosis looks a little like the letter Y.
Typically, the two upper limbs of the Y represent the proximal segment of stomach and the distal small bowel it joins with and 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 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. The procedure has also been associated with an increased incidence of iron-deficiency anemia. 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