Update in Bariatric Surgery

Abstract

Obesity is a systemic disease affecting different body systems including cardio-vascular, respiratory, hematology, reproductive, immunity, joint , Gastro-intestinal systems and the psycho-social burden of obesity is very important and may be the only complaint of the patient. In this essay, definition and methods for measurements of obesity were mentioned briefly and the anatomy, histology of the adipose t(ssue were reviewed. Pathophysiology, causes and co-morbidities of obesity were mentioned in brief. Different models of treatment of obesity including non-surgical and surgical were discussed. Since obesity is a multi-factorial disease, so, there are no standard rules for treatment , but every individual must be carefully examined to. rule-out the best line of treatment suitable for him. Non-surgical treatment include diet control, behavior therapy, exercise and pharmacotherapy. Non-surgical treatment offers un-satisfactory results. Thus, surgical treatment is considered the best line of management of obesity especially when the individual is suitable for operation and has no contra­ indications which were listed. A successful weight-loss operation. has two major goals: significant magnitude and duration of weight loss, and a reasonably low peri-operative and long term complication rate. The idea of surgery for obesity is based on either reducing absorption of food, reducing intake of food, or reducing both intake and absorption of food. Historical surgical procedures as JIB, BIB and gastric wrapping has been abounded • due to their high incidence of complications and failure to maintain weight loss. Current surgical options such as; gastric by-pass, gastroplasty and gastric banding are, nowadays, the most widely