In the 1950s, the first surgical procedures were performed to control the weight of severely obese patients. The first gastric bypass was performed in the 1960s and the first biliopancreatic bypass after Scopinaro in the mid-1970s. The first implantation of a gastric band took place in the mid-1990s. The procedures were initially performed "openly" through large incisions before minimally invasive techniques became established in 1994. Nowadays, bariatric surgery is performed exclusively laparoscopically through small incisions.
The range of surgical techniques used to treat obesity and their indications have changed over time. These changes can be divided into three phases: the pioneering phase in the 1950s and 1960s, the laparoscopic phase in the 1990s and the current metabolic phase, which is focused on the improvement or even elimination of obesity-related concomitant diseases such as diabetes mellitus type 2. In the 1990s, the main focus was on the implantation of the gastric band, but today the laparoscopic gastric sleeve and the laparoscopic gastric bypass are the most important.
The distribution of primary surgeries has changed significantly again in recent years. For the first time in 2014, more gastric sleeve surgeries were performed than gastric bypass surgeries. Both procedures are currently regarded as the gold standard in the surgical treatment of obesity.
The following surgical procedures are presented on the coming pages:
- gastric banding
- sleeve gastrectomy
- gastric bypass
- omega loop bypass ("mini gastric bypass")
- biliopancreatic diversion according to Scopinaro
- biliopancreatic diversion with duodenal switch
Bilbiography sources:
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Lo Menzo E, Szomstein S, Rosenthal RJ (2015) Changing Trends in Bariatric Surgery. Scand J Surg 104: 18–23
Müller MK, Wildi S, Clavien PA, Weber M (2006) Chirurgische Behandlung der morbiden Adipositas. In: Siewert JR, Rothmund M, Schumpelick V (Hrsg) Praxis der Viszeralchirurgie – Gastroenterologische Chirurgie, 2. Aufl. Springer, Heidelberg, S. 381–389
Pories WJ, Swanson MS, MacDonald KG et al (1995) Who would have thought it? An operation proves to be the most effective therapy for adult-onset diabetes mellitus. Ann Surg 222(3):339–350
Reining F, Aberle J (2014) Chirurgische Therapie der Adipositas. Internist 55:1383–1390
Rubino F, Nathan DM, Eckel RH et al (2016) Metabolic surgery in the treatment algorithm for Type 2 Diabetes: A joint statement by International Diabetes Organizations. Diabetes Care 39(6):861–877.
Runkel N, Colombo-Benkmann M, Hüttl TP, et al. (2011) Bariatric Surgery. Dtsch Arztebl Int 108: 341–346
