Laparoscopic Sleeve gastrectomy versus Minigastric bypass in management of Morbid Obesity

Abstract

Obesity is considered a major health and socio economic problem. Over weight, obesity and morbid obesity are terms often used to describe individuals with and increased body fat. The most common definition of morbid obesity is a body mass index (BMI).of 40Kg /m2 or more. More than 250 millions individuals are obese. The aetiology of this condition is multi factors including; familial and genetic predisposition, drug induced obesity, endocrinal causes, intake of food in large quantities and many times in the day, psychological factors, environmental factors, special habits like alcohol consumption and smoking and personal factors like; age, gender, ethinity and parity. Storage of excess calories as fat must ultimately result from a net positive energy balance (energy intake greater than energy expenditure).over time. Thus, the physiologic determinants of body composition are energy intake, energy output, and partitioning of energy stores as fat, carbohydrate, and protein. Many physiologic systems (endocrine, gastrointestinal, central nervous, peripheral nervous andcardiovascular).affect these functions. Small changes in any of these determinants can, over time, result in substantial changes in body weight Clear understanding of the pathophysiology of morbid obesity is essential for management and prevention of this disaster. There are several factors concerning the occurrence of obesity, the first one in this mechanism is the genetic control also central nervous system control, afferent signals, pattern of feeding, socioeconomic factors, exercise and pattern of distribution of excess adipose tissue, leptin also, have a role in the mechanism of this disease. Leptin is the best known of the afferent fat signals and the best candidate for primary signalcommunication of body fat information to the central controller.