Perspective on biomaterials used in the surgical treatment of morbid obesity

Abstract

Morbid obesity is defined as having a body mass index greater than or equal to 40.0 kg m(-2), or 37.0 kg m(-2) with comorbidities. Bariatric surgery remains the most effective treatment for morbid obesity. Bariatric procedures such as sleeve gastrectomy, vertical banded gastroplasty and adjustable gastric banding all generate excess body-weight loss typically over 3-5 years. The biomaterials used during these procedures, namely silicone, polypropylene, expanded polytetrafluoroethylene and titanium, are all non-degradable biomaterials. Hence, their presence in vivo exceeds the functional requirement of an implant to treat morbid obesity. Accordingly, research into non-invasive and reversible surgical procedures has increased, particularly in light of the dramatic increase in paediatric obesity. Tissue engineering is an alternative approach to treat morbid obesity, as it incorporates both engineering and biological principles into the design and development of an implant to surgically treat morbid obesity. It is hypothesized that a biodegradable polymer to treat morbid obesity could be developed to effectively promote excess weight loss. The aim of this review is to discuss morbid obesity with regards to its aetiology, prevalence and current modalities of treatment. Specifically, the shortcomings of the biomaterials currently used to surgically treat morbid obesity shall be reviewed, and alternative biomaterials shall be proposed.