History of Bariatric Surgery

Abstract

Obesity has been a problem for centuries and it has increased to a worldwide epidemic with severe implications on individual and public health. The history of bariatric surgery was born out of observations leading to investigation and advancement. Many dedicated surgeons searched for an ideal procedure to treat the rapidly growing epidemic of morbid obesity and alleviate the burden of comorbid conditions. Treating obesity has been challenging and advancements in surgery have led to increased success and durable results. Early operations were plagued by high morbidity and mortality. The ideal procedure must have low complication risk, both in short and long term, as well as durable and lasting results. Several techniques have been developed in the last 70 years benefiting from the advent of laparoscopy. Minimally invasive techniques created a revolution in bariatric surgery and have improved safety profiles leading to increased popularity and application. Although complex bariatric procedures can be performed with mortality rates similar to cholecystectomy, postoperative complications resulting from the altered anatomy and physiology must be considered. Advancements in techniques and quality monitoring from national and international societies have improved and standardized the delivery of bariatric surgery worldwide. The effects on metabolic conditions have widened the breadth of minimal invasive bariatric surgery into the field of metabolic surgery.