Laparoscopic gastric surgeries in Treatment of Morbid Obesity

Abstract

Bariatric surgery is an important tool in the fight against morbid obesity. Laparoscopic bariatric surgery is much better than open surgery due to less postoperative complication and shorter hospital stay. A discussion of the laparoscopic gastric surgical operations, the advantages and disadvantages of each one, how to manage its complications and how to select the proper operation to each individual was conducted.Laparoscopic adjustable gastric banding(LAGB) reduce the size of the stomach through silicone inflatable tube encircling small pouch from the stomach and its stoma can be calibrated. This makes patient feel early satiety and decrease caloric intake.Vertical Band Gastroplasty (VBG) reduce the size of the stomach by exclusion of part of the stomach without excision. Althoughit has less incidence of leakage but carries a risk of stable line dehiscence and fistula in the fundus of the stomach.Laparoscopic Roux-en-Y Gastric Bypass(LRYGB) reduces the size of the stomach and shorten the part of the bowel through which the food is digested and absorbed via bypassing the duodenum and part of the jejunum with higher risk of anastomotic leak.Sleeve gastrectomy is an effective procedure that reduces the stomach capacity and decrease ghrelin (ahormone affecting satiety center) via excision of part of the stomach but still has the risk of leakage and fistula formation.Biliopancreatic diversion (BPD) is a mal-absorptive procedure while Biliopancreatic Diversion with Duodenal Switch (BPD/DS) is acombined one acting by stomach size reduction (via addition of sleeve gastrectomy) and diverting bile and pancreatic secretion away from the food so food isn’t completely digested or absorbed.Gastric plication is anew emerging procedure that works by apposition of gastric walls (serosa to serosa) causing reduction of the stomach size with fewer complications. It gave promising results and still undertrial. Key words: Bariatric surgery, Laparoscopic bariatric surgery, Laparoscopic adjustable gastric banding (LAGB), Vertical Band Gastroplasty (VBG), Laparoscopic Roux-en-Y Gastric Bypass (LRYGB), Sleeve gastrectomy, Biliopancreatic diversion (BPD), Biliopancreatic Diversion with Duodenal Switch (BPD/DS), Gastric plication.