Changing Trends in Bariatric Surgery

Abstract

Background and Aims: Bariatric surgery is considered the only long-lasting treatment for morbid obesity. Techniques and procedures have changed dramatically. We report on some of the major changes in the field. Materials and Methods: We reviewed some of the major changes in trends in bariatric surgery based on some landmark paper published in the literature. Results: We identified three major phases in the evolution of bariatric surgery. The pioneer phase was mostly characterized by discovery of weight loss procedures serendipitously from procedures done for other purposes. The second phase can be identified with the advent of laparoscopic techniques. This is considered the phase of greatest expansion of bariatric surgery. The metabolic phase derives from the improved understanding of the mechanisms of actions of the bariatric operations at the hormonal and molecular level. Conclusions: Bariatric surgery has changed significantly over the years. The safety of the laparoscopic approach, along with the better understanding of the metabolic changes obtained postoperatively, has led to a more individualized approach and also an attempt to expand the indications for these procedures.

The gut in the brain: the effects of bariatric surgery on alcohol consumption

“…The RYGB procedure involves creating a stomach pouch out of a small portion of the stomach and attaching it directly to the small intestine, bypassing a large part of the stomach and the entire duodenum. Not only is the stomach pouch too small (0.5 to 1 ounce) to hold large amounts of food, but by bypassing the duodenum, fat absorption is substantially reduced (Lo Menzo et al 2015). With the sleeve gastrectomy, more than half of the stomach is removed, leaving a thin vertical sleeve.…”

Definitions of obesity and current indications for obesity surgery

“…[8,22] The indications of metabolic and obesity surgery should be based on not only BMI but also on metabolic comorbidities With the development of laparoscopic surgery, bariatric surgery has gained popularity and the indications of bariatric surgery have extended.…”

“…It rapidly b came the most commonly performed bariatric operation in the United States during the 1980s. [1,4,7] Afterwards [1,[8][9][10][11][12][13][14][15] There have been two major changes in the bariatric field recently. Firstly, laparoscopic development has increased the number of laparoscopic bariatric operations and made them easier than they were before.…”

“…Secondly, nowadays, the concept of bariatric surgery is covering the ability of surgical therapy to treat the metabolic consequences of obesity more than obesity itself. [2,8,[16][17][18] Bariatric and metabolic surgery are proven therapies for obesity and its comorbidities. With bariatric surgery, not only the resolution or improvements of co-morbidities such as diabetes, hypertension, hyperlipidemia, obstructive sleep apnea, gastroesophageal reflux, and pseudo tumor cerebri occur, but also the prevalence of development of some type of cancers like breast and colon cancers decrease.…”

The Newer Horizons in Bariatric Surgery

“…results as it could not achieve and maintain weight loss, and increased frequency of follow ups and poor long term results [3]. Moreover higher reoperation rates secondary to long term complication due to slippage, pouch dilatation , dysphagia and erosions contributed to its decline while as LAGB was decreasing in its popularity, SG was increasing in its reputation worldwide due to its technical ease, lesser complication and reoperation rates [4].…”