Single Anastomosis Doudenal Switch for Failed Sleeve Gastrectomy

Abstract

Obesity is simply defined as "excessive amount of body fat"; it is considered a great problem in both developed & developing nations. Obesity isa disease, and as such is in many respects not preventable. The components of this disease likely include a combination of environmental and genetic factors. The recent rapid rise in the incidence of obesity in less than a generation's time suggests that genetic causes alone cannot be responsible for the disease. Nevertheless, the multifactorial contributions to the disease increase the difficulty in understanding its causes. The degrees of obesity are defined by body mass index, or BMI (calculated as weight in kilograms divided by height in meters squared), which correlates body weight with height. Patients are classified as overweight, obese, or severely obese (sometimes referred to as morbidly obese) Significant comorbidities, defined as medical problems associated with or caused by obesity, are numerous. Diet, physical exercise or medical therapy has not proved to be efficient in treating morbid obesity in the long term. Surgical therapy is the only effective and proven therapy for patients with severe obesity (body mass index of ≥35 kg/m2). Bariatric operations prolong survival and resolve comorbid medical conditions associated with severe obesity. Bariatric surgery is also metabolic surgery, treating the varied metabolic consequences of the comorbid diseases arising from severe obesity. Bariatric operations involve either restriction of caloric intake or malabsorption of nutrients, or both. Long-term follow-up is essential before the merits of an operation can be confirmed. Malabsorptive operations are highly effective in producing durable weight loss but have considerable nutritional side effects. Patients undergoing such procedures require close follow-up and must take appropriate nutritional supplements.