Restrictive Surgery in Obesity Treatment

Publisher： Karger

E-ISSN： 2297-475x|21|1|3-6

ISSN： 2297-4725

Source： Visceral Medicine (formerly: Viszeralmedizin), Vol.21, Iss.1, 2005-04, pp. : 3-6

Disclaimer: Any content in publications that violate the sovereignty, the constitution or regulations of the PRC is not accepted or approved by CNPIEC.

Previous Menu Next

Abstract

Obesity is widely recognized as epidemic of the 21st century.Throughout Europe and the USA, it shows one of the greatestprevalences among serious life-threatening diseases. Thisoverview of historical development of restrictive bariatric proceduresand of basic patient selection criteria for restrictiveprocedures is based on a literature review as well as on almost20-year personal experience in bariatric surgery. Bariatricsurgical community accepts as routine procedures forobesity treatment three categories of interventions. i) Malabsorptiveoperations (i. e. biliopancreatic diversion and duodenalswitch) that control digestion and absorption of food.ii) Combined procedures (gastric bypass in several variations,i. e. short and long limb Roux-en-Y bypass) that combine effectof gastric volume restriction with a degree of malabsorptionwhich is determined by the length of bypassed intestine.iii) Restrictive operations (i. e. gastric banding and verticalbanded gastroplasty) restricting the amount of food that canbe eaten at a time. Although the operations can be performedeither by open surgery or laparoscopy, the majority of thembecame laparoscopic procedures. All bariatric procedures offerlong-term successful and substantial weight losses in appropriatelyselected patients. Restrictive procedures are theleast invasive within the bariatric surgical armamentariumbut necessitate patient-specific preoperative team assessmentand selection. Focused pre- and postoperative patienteducation might contribute to long-term weight losses anddecrease complication rates following restrictive procedures.