Table 2 The main phases of bypass procedures, by centre

Establishing a pneumoperitoneum and insertion of ports

To provide access to the abdominal cavity

1

1

Creation of the Roux limb

To divert the passage of food away from the first portion of small bowel

2

3

Jejuno-jejunostomy

3

5

Gastric pouch formation

To reduce the stomach volume

4

2

Gastro-jejunostomy formation

To join the stomach pouch to the end of the diverted portion of bowel

5

4

Closure

To reconstruct the layers of fat and muscle, re-creating how they looked before the operation

6

6