Conversion of a Remotely Performed Gastroplasty Procedure to a Roux-en-Y Gastric Bypass

摘要

Obesity has become one of the chronic diseases and affects over 500 million people worldwide. It is defined as a body mass index of greater than 30 kg/m2. It can be furthermore categorized into mild (30-34.9 kg/m2), moderate (35-39.9 kg/m2), or severe (>40 kg/m2).1 Historically, bariatric surgery has been divided into three categories; malabsorptive, malabsorptive/restrictive, and completely restrictive. Bariatric surgery began with strictly malabsorptive procedures such as the jejunoileal bypass in the 1950s, which was then followed by biliopancreatic diversion in the 1970s, and duodenal switch in the 1990s. After introduction of the jejunoileal bypass, a procedure known as gastric bypass with malabsorptive and restrictive properties was introduced. The gastric bypass, developed in the 1960s, has undergone several variations because its inception with the most common method is being performed laparoscopi-cally today. In the 1970s, completely restrictive bariatric surgery was introduced with a horizontal gastroplasty as the initial procedure. This was followed by a flurry of other restrictive procedures such as vertical banded gastroplasty, gastric banding, and most recently sleeve gastrectomy. In recent years, the number of bariatric procedures has increased and most are currently performed via a minimally invasive technique. The number of revi-sional procedures is increasing secondary to side effects or inferior weight loss. It is estimated that between 10 and 25 per cent of patients will require a revision at some point after their initial procedure.