RYGB is considered the gold standard. It consists of the creation of a gastric pouch smaller than 50 mL and Y-shaped reconfiguration of the small bowel, creating an alimentary or Roux-limb and a biliopancreatic limb. Therefore, this is a mixed procedure (restrictive and malabsorptive).

Due to the small gastric pouch, this procedure restricts the food intake, and on the other hand, due to the small bowel reconfiguration, it generates malabsorption of carbohydrates and fat. For this reason, this procedure will lead to significant and sustained weight loss.

One of the main advantages of this procedure is that it is related to a greater proportion of T2 diabetes remission, compared to Sleeve Gastrectomy, in addition to greater weight loss in some patients.

This procedure is the ideal one to do in those patients with gastroesophageal reflux disease (GERD), type 2 diabetes, and those who have a BMI > 45 kg/m2.

On the other hand, some of the limitations and disadvantages of this surgery are the increased risk for small bowel obstruction, the need for vitamin and mineral supplementation for life.

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