Principles and Results of Bariatric Surgery

Abstract

Bariatric surgery is followed by substantial and durable weight loss and associated with it favorable metabolic effects far beyond those achieved by lifestyle modifications and pharmacological treatments. The perioperative and postoperative morbidity and mortality have decreased significantly over the years to the level that bariatric surgery now can compare with other frequently recommended and well-accepted procedures such as cholecystectomy and hysterectomy. In fact, the postoperative mortality risk of bariatric surgery is far lower than that of coronary artery bypass surgery but with significantly greater improvement in long-term mortality. Much of the improvement in perioperative morbidity and mortality can be attributed to advances in many components of the care chain such as the introduction of laparoscopic surgery, as well as establishment of a nationwide center of excellence network and required outcome reporting. Extensive evidence on safety and efficacy supports bariatric surgery as the standard of care for treatment of severe obesity. Bariatric surgery reduces the risk of global mortality, all-cause mortality and cardiovascular mortality when compared to obese control patients. Both gastric banding and gastric bypass seem to reduce mortality risk.

Is the Band a Good Procedure Choice, and for Whom Should We Still Consider It?

“…Data from Tice et al [3]. Pooled data from systematic review [16] with a weighted mean %EWL for the principal procedures.…”

“…Although early complications of LAGB are typically secondary to technical issues associated with band placement, port site, or wound issues, patients who undergo LAGB are predisposed to developing unique ''late'' band-related complications. Such complications include band slippage, band deflation from a ruptured balloon or inflation port breakage, infection of the band or subcutaneous port, and band erosion through the gastric lumen [16] (Table 5). It is estimated that up to 33 % of patients who undergo LAGB will require a reoperation or revision to another bariatric procedure either secondary to band-specific complications or inadequate weight loss [12,16,17].…”

“…Such complications include band slippage, band deflation from a ruptured balloon or inflation port breakage, infection of the band or subcutaneous port, and band erosion through the gastric lumen [16] (Table 5). It is estimated that up to 33 % of patients who undergo LAGB will require a reoperation or revision to another bariatric procedure either secondary to band-specific complications or inadequate weight loss [12,16,17]. Late problems after band placement have differed greatly in incidence since the introduction of LAGB in 1993 [12].…”

An Overview of the Effects of Various types of Bariatric Surgical Operations in the Azerbaijani Population

“…Surgical treatment of obesity came up with application and variety of several surgical procedures. Though initial historical information on such operations date back in 1950s, more efficient surgical procedures have begun to be formed since 1979 [3]. However, last breaking point of bariatric-metabolic surgery began in 1992 with adoption of concept on correction of such operations only in surgical way with permanent effects by World Health Organization.…”

Internal hernia in late pregnancy after laparoscopic Roux-en-Y gastric bypass

“…Laparoscopic Roux-en-Y gastric bypass (LRYGB) is currently the most commonly performed bariatric procedure1 2 providing excellent long-term results with low morbidity and mortality 1. However, one of the most challenging complications of LRYGB is the occurrence of an internal hernia (IH), which can lead to bowel necrosis and lethal sepsis if not treated accurately.…”