From the Knife to the Endoscope-a History of Bariatric Surgery.

PURPOSE OF REVIEW: Current bariatric surgical practice has developed from early procedures, some of which are no longer routinely performed. This review highlights how surgical practice in this area has developed over time. RECENT FINDINGS: This review outlines early procedures including jejuno-colic and jejuno-ileal bypass, initial experience with gastric bypass, vertical banded gastroplasty and biliopancreatic diversion with or without duodenal switch. The role laparoscopy has played in the widespread utilization of surgery for treatment of obesity will be described, as will the development of procedures which form the mainstay of current bariatric surgical practice including gastric bypass, sleeve gastrectomy and adjustable gastric banding. Endoscopic therapies for the treatment of obesity will be described. By outlining how bariatric surgical practice has developed over time, this review will help practicing surgeons understand how individual procedures have evolved and also provide insight into potential future developments in this field.

From the Knife to the Endoscope-a History of Bariatric Surgery.

PURPOSE OF REVIEW: This review was conducted to gain insight into the history, present and future of bariatric and/or metabolic surgery and endoscopic treatments of obesity. The challenges that have been overcome, the challenges we still face and our recommendations for the future are discussed. RECENT FINDINGS: Over the last few decades, a number of treatment strategies have emerged for the treatment of obesity. Both endoscopic and surgical options are available and they lead to significant weight loss and comorbidity reduction. However, to remain a credible treatment alternative to the obesity pandemic, we need to perform these procedures in much larger numbers than we currently do. Even though significant gains have been made in reducing the morbidity and mortality of surgical interventions, there is further room for improvement, especially when it comes to long-term issues. Due to its impact on almost every single organ system in the human body, bariatric surgery has attracted the attention of academics from a variety of medical disciplines. This has led to a rapidly enlarging body of high-quality scientific literature, supporting its wider use and cost-effectiveness. CONCLUSION: Despite the advances made in bariatric surgery, the criteria determining suitability of patients for bariatric surgery in most parts of the world are still based on a consensus agreed upon in the USA in 1991. There is a need to formulate some new consensus and guidelines that would allow for a significant expansion of the pool of patients that can be offered these procedures.

A History of Bariatric Surgery: The Maturation of a Medical Discipline.

This article examines the progression of bariatric surgery since its creation more than 60 years ago with a focus on the effect of surgery on weight loss, comorbidity reduction, and safety. The success has been remarkable. It is possible to cure severe obesity, type 2 diabetes, and hyperlipidemia in addition to the many other manifestations of the metabolic syndrome with remarkable safety. Equally important are the opportunities for research afforded by the surgery and its outcomes. Until better treatments become available, bariatric surgery is the therapy of choice for patients with morbid obesity for weight control and comorbidity improvement.

A history of intragastric balloons.

The history of intragastric balloons (IGBs) began in 1985 with the Garren-Edwards Bubble. It was approved by the U.S. Food and Drug Administration (FDA) for temporary use as a weight loss device, but its manufacture was discontinued in 1988, and approval was withdrawn in 1992 because of significant complications and limited and recidivistic weight loss. A number of IGBs have appeared since that time, mostly originating in Europe or South America, but none has acquired FDA approval until recently; the ReShape Duo Integrated Dual Balloon System (ReShape Medical Inc., San Clemente, California) received FDA approval in August 2015. The conclusions of an important 1987 international conference on IGBs and the characteristics, effectiveness, and problems of most other IGBs are described in this text. The common purpose of these devices as preliminary interventions before gastric bariatric surgery and their favorable effects on this purpose are emphasized and may have played a key role in the FDA's change of outlook of the IGB.

History and current status of bariatric and metabolic surgeries in East Asia.

Morbid obesity and obesity-related comorbidities are major public health problems around the world, including in East Asia. Although Asian populations have been shown to have an elevated risk of type 2 diabetes mellitus, hypertension, and hyperlipidemia at a relatively lower BMI than Western populations, the Asian perspective on bariatric and metabolic surgeries has not been actively discussed until recently. Bariatric surgery in East Asia has undergone a paradigm shift since the first laparoscopic vertical bariatric surgery was performed in Taiwan in 1998, which was subsequently followed by the introduction of laparoscopic adjustable gastric banding, Roux-en-Y gastric bypass, and mini-gastric bypass. Since 2006, use of laparoscopic sleeve gastrectomy has remarkably increased because of its ease, speed, and safety. With regard to metabolic surgery, a randomized controlled trial in Taiwan demonstrated that laparoscopic Roux-en-Y gastric bypass is more effective than laparoscopic sleeve gastrectomy for surgical treatment of poorly controlled type 2 diabetes mellitus and metabolic syndrome. In this article, we describe the history of bariatric procedures, revision surgeries, weight-loss effect, and metabolic surgeries in Asian populations, and we also discuss minimally invasive bariatric surgery with some important citations.

The history and evolution of bariatric surgical procedures.

The search for the ideal weight loss operation began more than 50 years ago. Surgical pioneers developed innovative procedures that initially created malabsorption, then restricted volume intake, and eventually combined both techniques. Variations, alterations, and modifications of these original procedures, combined with intense efforts to follow and document outcomes, have led to the evolution of modern bariatric surgery. More recent research has focused on the hormonal and metabolic effects of these procedures. These discoveries at the cellular level will help develop possible mechanisms of weight loss and comorbidity reduction beyond the traditional explanation of reduced food consumption and malabsorption.

Manejo nutricional del niño obeso / Nutritional management of obese children

La obesidad constituye un problema grave de salud pública. La OMS la define como una acumulaciónanormal o excesiva de grasa que puede ser perjudicial para la salud. La prevalencia se ha incrementado.Enfermedad crónica, compleja y multifactorial, en la que interaccionan factores genéticos y ambientales. Elíndice de Quételet o índice de masa corporal (IMC), es usado para estimar la gravedad. La valoración inicialdebe incluir exploración física y valorar el desarrollo puberal. Se asocia, con complicaciones inmediatas,int e rmedi a s y t a rdí a s . El t r a t ami ento e s multidisciplinario e individualizado. La cirugía en la población pediátrica está limitada. No se debe perder de vista que la solución ideal a este problema es laprevención.

Obesity is a serious public health problema. WHO defines it as an accumulation of abnormal or excessive fat that can be harmful to health. The prevalence has increased. It's a chronic, complex and multifactorial patology, in which genetic and environmental factors interact. Quetelet index or body mass index is used to estímate the severity. The initial assessment should include physical examination and assess pubertal development. It is associated with immediate, intermédiate and late complications. The treatment is multidisciplinary and individualized. Surgery in the pediatric population is limited. Do not forget that the ideal solution to this problema is prevention.

Evolution of operative procedures for the management of morbid obesity 1950-2000.

BACKGROUND: At the turn of the 21st century, obesity is the epidemic with the greatest prevalence in the United States. Fifteen million people, 1 out of 20, in this country have a body mass index (BMI) > or = 35 kgm2. Obesity is not only a medical problem, but also a social, psychological, and economic problem. At present, the morbidly obese are refractory to diet and drug therapy, but have a substantial, sustained weight loss after bariatric surgery. METHODS: This chronology of the landmark operations in bariatric surgery is based on a review of the medical literature. RESULTS: Bariatric surgery can be classified into 4 categories: malabsorptive procedures, malabsorptive/restrictive procedures, restrictive procedures, and other, experimental procedures. The prototype of malabsorptive procedures and the first operation performed specifically to induce weight loss was the jejunoileal bypass. The problems associated with this operation caused its demise. Today's popular malabsorptive procedures are the biliopancreatic diversion and the duodenal switch. Malabsorptive/restrictive surgery currently is predicated on the Roux-en-Y gastric bypass, both the traditional short-limb, and the long-limb for the super obese. Restrictive procedures are represented by the banded and ringed vertical gastroplasty, as well as gastric banding. Experimental procedures include gastric pacing. All of these operations can be performed by open surgery and laparoscopically. CONCLUSIONS: Since bariatric surgery is the only broadly successful treatment for morbid obesity, it is incumbent on all physicians to be familiar with current bariatric operations, and to understand the evolution of bariatric surgery.

[The development of bariatric surgery and the role of the First Surgical Clinic of the General Medical School Hospital and the First Medical School of Charles University in Prague in this specialty]. / Vývoj bariatrické chirurgie a úloha I. chirurgické kliniky VFN a 1. LF UK v Praze v tomto oboru.

The authors discuss the development of bariatric surgery in Europe and the USA from its beginnings at the onset of the fifties. More detailed attention is paid in particular to the development of the method of gastric bandings and the role at the First Surgical Department in this field in "classical" as well as miniinvasive surgery. Results of gastric banding are summarized in 683 patients operated since 1983, in particular the numbers of early and late complications after laparotomies and laparoscopic operations, similarly as complications which are directly associated with gastric banding itself. In the conclusion it is stated that the First Surgical Department of the General Faculty Hospital and First Medical Faculty Charles University in Prague belong as regards their results in surgical treatment of obese subjects and the position in the field of bariatric surgery on an international scale to the foremost departments in this field worldwide.