BARIATRIC SURGERY; RISK AND BENEFIT

Issam Merdan

doi:10.33762/bsurg.2007.56197

Abstract

Obese patients loss more weight with bariatric surgery than with medical weight loss treatment. The laparoscopic Roux-en-Y gastric bypass procedure results in more short term weight loss than laparoscopic adjustable gastric banding, but the latter has fewer postoperative complication and lower mortality rate; long term comparative data are currently lacking. The decision regarding which procedure to perform should be based on individual patient and surgeon factors. Early complications of gastric bypass surgery are bleeding, anastomotic leak, wound infection, thromboembolism, and anastomotic stricture. Longer term complication scan include marginal ulcers, bowel obstruction, gallstones, and nutritional deficiencies. Complication of adjustable gastric banding includes prolapsed and erosion. Patient typically loses more than 50% of their excess weight after bariatric surgery. Obesity related diseases markedly improve after bariatric surgery, reducing cardiovascular risk and improving life expectancy. Patient undergoing bariatric surgery must commit to a program of lifestyle changes, diet, vitamin supplementation, and follow-up.

Highlights

Outcome of bariatric surgery are getting better all the time, as surgeons gain experience in performing these technically demanding procedures laparoscopically
The benefits: do patients lose weight and keep it off, there are convincing data that many patients are cured of obesity related diseases, notably type 2 diabetes
Bariatric surgery; risk and benefit and laparoscopic Roux-en- Y gastric bypass showed no difference in mortality rates

Summary

Introduction

Outcome of bariatric surgery are getting better all the time, as surgeons gain experience in performing these technically demanding procedures laparoscopically. In this procedure, which can be performed either laparoscopically or as open surgery, food intake is restricted by creating a small (15–30 mL) gastric pouch, and absorption is limited by bypassing the proximal intestine with a Roux limb (Figure 1). The Roux-en-Y gastric bypass accounts for approximately 80% of all bariatric procedures performed in the United States.

Results

Conclusion