Long limb Roux en Y gastric bypass revisited

Roux-en-Y gastric bypass (RYGB) that is performed with at least a 150-cm Roux limb results in significantly greater weight loss than shorter (< 100-cm) Roux limb procedures in superobese patients (BMI >= 50 kg/m(2)). Conversely, longer Roux limb procedures do not provide greater weight loss in less obese (BMI < 50 kg/m(2)) patients. Modest elongation of the Roux limb-in the range of 150 cm to 200 cm-does not result in more frequent nutritional sequelae compared with shorter Roux limb procedures. This article discusses the current status of long limb Roux-en-Y gastric bypass in the context of weight loss, metabolic sequelae and CPT coding.