ABSTRACT
Bariatric surgery is the current standard treatment for severe obesity. A variety of procedures are currently performed, which provide durable and rapid weight loss through malabsorption, restriction, or a combination of the two. The significant amelioration of obesity-associated comorbidities has been demonstrated. Laparoscopic techniques in bariatric surgery provide patients with decreased morbidity and faster recovery, with an equivalent amount of weight loss. Weight loss is dramatic and progressive until a plateau is reached. Patients often seek the services of a plastic surgeon to remove the excess lax skin and improve the ptosis associated with such massive weight loss.
KEYWORDS
Morbid obesity - bariatric surgery - adjustable gastric band - biliopancreatic diversion - gastric bypass
REFERENCES
1
Livingston E H.
Procedure incidence and in-hospital complication rates of bariatric surgery in the United States.
Am J Surg.
2004;
188
105-110
2
Brolin R E.
Update: NIH consensus conference. Gastrointestinal surgery for severe obesity.
Nutrition.
1996;
12
403-404
3 National Institutes of Health .The practical guide: identification, evaluation and treatment of overweight and obesity in adults. June 17, 1998 Available at: http://www.nhlbi.nih.gov/guidelines/obesity/practgde.htm Accessed December 20, 2005
4
Nguyen N T, Goldman C, Rosenquist C J et al..
Laparoscopic versus open gastric bypass: a randomized study of outcomes, quality of life, and costs.
Ann Surg.
2001;
234
279-291
5
Schauer P R, Ikramuddin S, Gourash W, Ramanathan R, Luketich J.
Outcomes after laparoscopic roux-en-Y gastric bypass for morbid obesity.
Ann Surg.
2000;
232
515-529
6
Nguyen N T, Lee S L, Goldman C et al..
Comparison of pulmonary function and postoperative pain after laparoscopic versus open gastric bypass: a randomized trial.
J Am Coll Surg.
2001;
192
469-476
7
Balsiger B M, Poggio J L, Mai J, Kelly K A, Sarr M G.
Ten and more years after vertical banded gastroplasty as primary operation for morbid obesity.
J Gastrointest Surg.
2000;
4
598-605
8
Nightengale M L, Sarr M G, Kelly K A, Jensen M D, Zinsmeister A R, Palumbo P J.
Prospective evaluation of vertical banded gastroplasty as the primary operation for morbid obesity.
Mayo Clin Proc.
1991;
66
773-782
9
Fielding G A, Ren C J.
Laparoscopic adjustable gastric band.
Surg Clin North Am.
2005;
85
129-140
10
DeMaria E J.
Laparoscopic adjustable silicone gastric banding: complications.
J Laparoendosc Adv Surg Tech A.
2003;
13
271-277
11
Biertho L, Steffen R, Ricklin T et al..
Laparoscopic gastric bypass versus laparoscopic adjustable gastric banding: a comparative study of 1,200 cases.
J Am Coll Surg.
2003;
197
536-544
12
Weber M, Müller M K, Bucher T et al..
Laparoscopic gastric bypass is superior to laparoscopic gastric banding for treatment of morbid obesity.
Ann Surg.
2004;
240
975-982
13
Scopinaro N, Adami G F, Marinari G M et al..
Biliopancreatic diversion.
World J Surg.
1998;
22
936-946
14
Marceau P, Hould F-S, Simard S et al..
Biliopancreatic diversion with a duodenal switch.
World J Surg.
1998;
22
947-954
15
Gagner M, Matteotti R.
Laparoscopic biliopancreatic diversion with duodenal switch.
Surg Clin North Am.
2005;
85
141-149
16
Deveney C W, MacCabee D, Marlink K et al..
Roux-en-Y divided gastric bypass results in the same weight loss as duodenal switch for morbid obesity.
Am J Surg.
2004;
187
655-659
17
DeMaria E J.
Is gastric bypass superior for the surgical treatment of obesity compared with malabsorptive procedures?.
J Gastrointest Surg.
2004;
8
401-403
18
Herron D M.
Biliopancreatic diversion with duodenal switch vs. gastric bypass for severe obesity.
J Gastrointest Surg.
2004;
8
406-407
19
Schauer P R, Ikramuddin S, Hamad G et al..
Laparoscopic gastric bypass surgery: current technique.
J Laparoendosc Adv Surg Tech A.
2003;
13
229-239
20
Brolin R E.
Gastric bypass.
Surg Clin North Am.
2001;
81
1077-1095
21
Higa K D, Boone K B, Ho T.
Complications of the laparoscopic Roux-en-Y gastric bypass: 1,040 patients-what have we learned?.
Obes Surg.
2000;
10
509-513
22
Schwartz M L, Drew R L, Roiger R W, Ketover S R, Chazin-Caldie M.
Stenosis of the gastroenterostomy after laparoscopic gastric bypass.
Obes Surg.
2004;
14
484-491
23
Nguyen N T, Stevens C M, Wolfe B M.
Incidence and outcome of anastomotic stricture after laparoscopic gastric bypass.
J Gastrointest Surg.
2003;
7
997-1003
24
Garza E, Kuhn J, Arnold D, Nicholson W, Reddy S, McCarty T.
Internal hernias after laparoscopic Roux-en-Y gastric bypass.
Am J Surg.
2004;
188
796-800
25
Stocker D J.
Management of the bariatric surgery patient.
Endocrinol Metab Clin North Am.
2003;
32
437-457
26
Sugerman H J, Brewer W H, Shiffman M L et al..
A multicenter, placebo-controlled, randomized, double-blind, prospective trial of prophylactic ursodiol for the prevention of gallstone formation following gastric-bypass-induced rapid weight loss.
Am J Surg.
1995;
169
91-96
27
Wittgrove A C, Clark G W.
Laparoscopic gastric bypass, Roux-en-Y-500 patients: technique and results, with 3-60 month follow-up.
Obes Surg.
2000;
10
233-239
28
Schauer P R, Burguera B, Ikramuddin S et al..
Effect of laparoscopic Roux-en Y gastric bypass on type 2 diabetes mellitus.
Ann Surg.
2003;
238
467-483
29
Sugerman H J, Wolfe L G, Sica D A, Clore J N.
Diabetes and hypertension in severe obesity and effects of gastric bypass-induced weight loss.
Ann Surg.
2003;
237
751-756
30
Pories W J, Swanson M S, MacDonald K G et al..
Who would have thought it? An operation proves to be the most effective therapy for adult-onset diabetes mellitus.
Ann Surg.
1995;
222
339-350
31
MacDonald K G, Long S D, Swanson M S et al..
The gastric bypass operation reduces the progression and mortality of non-insulin-dependent diabetes mellitus.
J Gastrointest Surg.
1997;
1
213-220
32
Dhabuwala A, Cannan R J, Stubbs R S.
Improvement in co-morbidities following weight loss from gastric bypass surgery.
Obes Surg.
2000;
10
428-435
33 Sacks J, Sterry T P. Plastic surgery after excessive weight loss . In: Inabnet WB, DeMaria EJ, Ikramuddin S Laparoscopic Bariatric Surgery. Philadelphia, PA; Lippincott Williams & Wilkins 2005: 314-324
34
Acarturk T O, Wachtman G, Heil B et al..
Panniculectomy as an adjuvant to bariatric surgery.
Ann Plast Surg.
2004;
53
360-366
35
Knoetgen J, Petty P M, Johnson C H.
Plastic surgery after bariatric surgery and massive weight loss.
Mayo Clin Proc.
2005;
80
136
Samer G MattarM.D. F.A.C.S.
Director, Clarian Bariatric Center, Department of Surgery, Indiana School of Medicine
6625 Network Way, Suite 100, Indianapolis, IN 46728