Surgical Treatment of Obesity and the Metabolic Syndrome

2020 ◽  
Author(s):  
Iman Ghaderi ◽  
Nisha Dhanabalsamy ◽  
Carlos A Galvani

Obesity and obesity-related comorbid conditions have been steadily increasing in the United States over the past few decades. Despite the availability of several anti-obesity measures such as diet, exercise, pharmacotherapy and behavioral modifications, bariatric surgery is the only effective modality that can provide a sustainable long-term weight loss and improve obesity-associated comorbidities. In this chapter, we discuss perioperative assessment and work-up of morbidly obese patients, minimally invasive approaches to various bariatric surgery procedures including laparoscopic adjustable gastric band, sleeve gastrectomy, gastric bypass and biliopancreatic diversion with duodenal switch, and their short and long term outcomes. We also address revisional bariatric surgery and use of robotic platform and other new procedures and their role in metabolic and bariatric surgery. This review contains 7 figures, 2 videos, 2 tables, and 110 references. Keywords: Obesity, comorbidities, metabolic surgery, bariatric surgery, gastric bypass, adjustable gastric band, sleeve gastrectomy, Biliopancreatic Diversion with Duodenal Switch, revisional surgery

2020 ◽  
Author(s):  
Iman Ghaderi ◽  
Nisha Dhanabalsamy ◽  
Carlos A Galvani

Obesity and obesity-related comorbid conditions have been steadily increasing in the United States over the past few decades. Despite the availability of several anti-obesity measures such as diet, exercise, pharmacotherapy and behavioral modifications, bariatric surgery is the only effective modality that can provide a sustainable long-term weight loss and improve obesity-associated comorbidities. In this chapter, we discuss perioperative assessment and work-up of morbidly obese patients, minimally invasive approaches to various bariatric surgery procedures including laparoscopic adjustable gastric band, sleeve gastrectomy, gastric bypass and biliopancreatic diversion with duodenal switch, and their short and long term outcomes. We also address revisional bariatric surgery and use of robotic platform and other new procedures and their role in metabolic and bariatric surgery. This review contains 7 figures, 2 videos, 2 tables, and 110 references. Keywords: Obesity, comorbidities, metabolic surgery, bariatric surgery, gastric bypass, adjustable gastric band, sleeve gastrectomy, Biliopancreatic Diversion with Duodenal Switch, revisional surgery


2015 ◽  
Vol 28 (suppl 1) ◽  
pp. 79-83 ◽  
Author(s):  
Matheo Augusto Morandi STUMPF ◽  
Marcos Ricardo da Silva RODRIGUES ◽  
Ana Claudia Garabeli Cavalli KLUTHCOVSKY ◽  
Fabiana TRAVALINI ◽  
Fábio Quirillo MILLÉO

Background : Due to the increased prevalence of obesity in many countries, the number of bariatric surgeries is increasing. They are considered the most effective treatment for obesity. In the postoperative there may be difficulties with the quality of alimentation, tolerance to various types of food, as well as vomiting and regurgitation. Few surveys are available to assess these difficulties in the postoperative. Aim : To perform a systematic literature review about food tolerance in patients undergoing bariatric surgery using the questionnaire "Quality of Alimentation", and compare the results between different techniques. Method : A descriptive-exploratory study where the portals Medline and Scielo were used. The following headings were used in english, spanish and portuguese: quality of alimentation, bariatric surgery and food tolerance. A total of 88 references were found, 14 used the questionnaire "Quality of Alimentation" and were selected. Results : In total, 2745 patients were interviewed of which 371 underwent to gastric banding, 1006 to sleeve gastrectomy, 1113 to Roux-en-Y gastric bypass, 14 to biliopancreatic diversion associated with duodenal switch, 83 were non-operated obese, and 158 non-obese patients. The questionnaire showed good acceptability. The biliopancreatic diversion with duodenal switch had the best food tolerance in the postoperative when compared to other techniques, but it was evaluated in a single article with a small sample. The longer the time after the operation, the better is the food tolerance. Comparing the sleeve gastrectomy and the Roux-en-Y gastric bypass, there are still controversial results in the literature. The gastric banding had the worst score of food tolerance among all the techniques evaluated. Conclusion: The questionnaire is easy and fast to assess the food tolerance in patients after bariatric surgery. Biliopancreatic diversion with duodenal switch had the best food tolerance in the postoperative when compared to sleeve gastrectomy and the Roux-en-Y gastric bypass. Gastric banding still remains in controversy, due it presented the worst score.


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