This is a malabsorptive procedure in which the stomach size is reduced to 90% or more, of its normal size. In order to achieve this, a small pouch that can be 1 to 3 oz, is made in the top portion of the stomach by making an incision. A second incision is made in the second portion of the small intestine (jejunum), which is then connected to the pouch that was mentioned earlier. In order to allow digestive juices from the stomach into the small intestine the surgeon creates a passage way into the “new” route that food takes. This is one of the more laborious bariatric procedures, but is one that helps patients with morbid obesity.