{"id":4749,"date":"2023-03-14T10:38:07","date_gmt":"2023-03-14T09:38:07","guid":{"rendered":"https:\/\/ifso-ec.refreshpixel.com\/?page_id=4749"},"modified":"2023-04-05T13:28:15","modified_gmt":"2023-04-05T11:28:15","slug":"bariatric-surgery","status":"publish","type":"page","link":"https:\/\/ifssoecbackup.ypo.pw\/bariatric-surgery\/","title":{"rendered":"Bariatric surgery"},"content":{"rendered":"\n

Bariatric surgery is a surgical intervention that causes changes in the alimentary tract that lead to weight loss in a short period of time. It is the most effective obesity treatment option.<\/p>\n\n\n\n

There are a variety of different techniques, each one with its own particularity, indication and side effects. The decision to offer surgery should be provided by an experienced bariatric surgeon, and a multidisciplinary assessment in a specialized center is recommended. Unlike non-surgical treatment, the surgical options should not be offered in a step-up basis. The best procedure for a particular patient should be provided in the first place<\/strong>, for the best long-term results and safety.<\/p>\n\n\n\n

Nowadays minimally invasive techniques (laparoscopy and robotics) are the standard procedure.<\/p>\n\n\n\n

Surgical interventions were classically classified according to their influence in the alimentary tract as restrictive, hypoabsorptive\/malabsorptive or combined. Today it is recognized that none of the effects are totally isolated<\/strong>.  Moreover, all have in common a metabolic effect<\/strong> with different intensities, which is characterized by the ability of changing the hormonal environment and induce changes in control of metabolic diseases (such as type 2 diabetes), fertility, sensation of hunger, satiety, and energy expenditure capacity.<\/p>\n\n\n\n

Surgical techniques<\/strong><\/h2>\n\n\n\n

Several procedures are described in the literature, nevertheless the most performed and accepted by the societies dedicated to obesity management are mentioned below(2):<\/p>\n\n\n\n

\n
Adjustable Gastric Banding<\/strong><\/a><\/div>\n\n\n\n
Sleeve Gastrectomy<\/strong><\/a><\/div>\n\n\n\n
Roux-en-Y Gastric Bypass<\/strong><\/a><\/div>\n\n\n\n
One Anastomosis Gastric Bypass<\/strong><\/a><\/div>\n<\/div>\n\n\n\n

Superobesity<\/strong><\/h2>\n\n\n\n

The following techniques have a more pronounced hypoabsorptive effect <\/strong>and are indicated for morbid and superobese patients. They are composed by two parts that can be performed in one or two surgical steps. The first part is a sleeve gastrectomy.<\/p>\n\n\n\n

Another particularity of these techniques is the preservation of the pylorus. This anatomical structure function as a valve in the way out of the stomach and controls gastric emptying as well as prevent reflux of the content below the stomach.<\/p>\n\n\n\n

Superior results in metabolic diseases as type 2 diabetes are well-described, which highlights the metabolic effect<\/strong> of both procedures.<\/p>\n\n\n\n

Despite the great results in weight loss and comorbidities resolution, concerns regarding nutritional deficits and technical complexity lead to a decrease in the performance of this techniques (less than 2% worldwide), reconsidered lately with the introduction of the two-step approach.<\/p>\n\n\n\n

\n
Biliopancreatic Diversion with Duodenal Switch<\/strong><\/strong><\/a><\/div>\n\n\n\n
Single Anastomosis Duodeno-Ileal with Sleeve gastrectomy<\/strong><\/strong><\/a><\/div>\n<\/div>\n\n\n\n

References<\/h2>\n\n\n\n

1.        Eisenberg D, Shikora SA, Aarts E, Aminian A, Angrisani L, Cohen R v., et al. 2022 American Society for Metabolic and Bariatric Surgery (ASMBS) and International Federation for the Surgery of Obesity and Metabolic Disorders (IFSO): Indications for Metabolic and Bariatric Surgery. Surgery for Obesity and Related Diseases. 2022 Oct;<\/p>\n\n\n\n

2.        di Lorenzo N, Antoniou SA, Batterham RL, Busetto L, Godoroja D, Iossa A, et al. Clinical practice guidelines of the European Association for Endoscopic Surgery (EAES) on bariatric surgery: update 2020 endorsed by IFSO-EC, EASO and ESPCOP. Surg Endosc. 2020 Jun 23;34(6):2332\u201358.<\/p>\n\n\n\n

3.        Goyal D, Watson RR. Endoscopic Bariatric Therapies. Curr Gastroenterol Rep. 2016 Jun 20;18(6):26.<\/p>\n\n\n\n

4.        Gloy VL, Briel M, Bhatt DL, Kashyap SR, Schauer PR, Mingrone G, et al. Bariatric surgery versus non-surgical treatment for obesity: a systematic review and meta-analysis of randomised controlled trials. BMJ. 2013 Oct 22;347(oct22 1):f5934\u2013f5934.<\/p>\n\n\n\n

5.        Genco A, Soricelli E, Casella G, Maselli R, Castagneto-Gissey L, di Lorenzo N, et al. Gastroesophageal reflux disease and Barrett\u2019s esophagus after laparoscopic sleeve gastrectomy: a possible, underestimated long-term complication. Surgery for Obesity and Related Diseases. 2017 Apr;13(4):568\u201374.<\/p>\n\n\n\n

6.        Angrisani L, Santonicola A, Iovino P, Vitiello A, Higa K, Himpens J, et al. IFSO Worldwide Survey 2016: Primary, Endoluminal, and Revisional Procedures. Obes Surg. 2018;28(12):3783\u201394.<\/p>\n\n\n\n

7.        Skogar ML, Sundbom M. Duodenal Switch Is Superior to Gastric Bypass in Patients with Super Obesity when Evaluated with the Bariatric Analysis and Reporting Outcome System (BAROS). Obes Surg. 2017;27(9):2308\u201316.<\/p>\n\n\n\n

8.        Prachand VN, DaVee RT, Alverdy JC. Duodenal switch provides superior weight loss in the super-obese (BMI \u226550kg\/m2) compared with gastric bypass. Ann Surg. 2006;244(4):611\u20137.<\/p>\n\n\n\n

9.        de Luca M, Tie T, Ooi G, Higa K, Himpens J, Carbajo MA, et al. Mini Gastric Bypass-One Anastomosis Gastric Bypass (MGB-OAGB)-IFSO Position Statement. Obes Surg. 2018 May 29;28(5):1188\u2013206.<\/p>\n\n\n\n

10.      Marceau P, Biron S, Marceau S, Hould FS, Lebel S, Lescelleur O, et al. Long-Term Metabolic Outcomes 5 to 20 Years After Biliopancreatic Diversion. Obes Surg. 2015;<\/p>\n\n\n\n

11.      Gebell\u00ed JP, Lazzara C, de Gordejuela AGR, Nora M, Pereira AM, S\u00e1nchez-Pernaute A, et al. Duodenal Switch vs. Single-Anastomosis Duodenal Switch (SADI-S) for the Treatment of Grade IV Obesity: 5-Year Outcomes of a Multicenter Prospective Cohort Comparative Study. Obes Surg. 2022 Oct 25;<\/p>\n\n\n\n

12.      Pereira AM, Guimar\u00e3es M, Pereira SS, Ferreira de Almeida R, Monteiro MP, Nora M. Single and dual anastomosis duodenal switch for obesity treatment: a single-center experience. Surgery for Obesity and Related Diseases. 2021;17(1).<\/p>\n\n\n\n

13.      Finno P, Osorio J, Garc\u00eda-Ruiz-de-Gordejuela A, Casajoana A, Sorribas M, Admella V, et al. Single Versus Double-Anastomosis Duodenal Switch: Single-Site Comparative Cohort Study in 440 Consecutive Patients. Obes Surg. 2020;(April).<\/p>\n","protected":false},"excerpt":{"rendered":"

Bariatric surgery is a surgical intervention that causes changes in the alimentary tract that lead to weight loss in a…<\/p>\n","protected":false},"author":2,"featured_media":4751,"parent":0,"menu_order":23,"comment_status":"closed","ping_status":"closed","template":"","meta":{"footnotes":""},"class_list":["post-4749","page","type-page","status-publish","has-post-thumbnail","hentry"],"acf":[],"_links":{"self":[{"href":"https:\/\/ifssoecbackup.ypo.pw\/api\/wp\/v2\/pages\/4749","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/ifssoecbackup.ypo.pw\/api\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/ifssoecbackup.ypo.pw\/api\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/ifssoecbackup.ypo.pw\/api\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/ifssoecbackup.ypo.pw\/api\/wp\/v2\/comments?post=4749"}],"version-history":[{"count":18,"href":"https:\/\/ifssoecbackup.ypo.pw\/api\/wp\/v2\/pages\/4749\/revisions"}],"predecessor-version":[{"id":5134,"href":"https:\/\/ifssoecbackup.ypo.pw\/api\/wp\/v2\/pages\/4749\/revisions\/5134"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/ifssoecbackup.ypo.pw\/api\/wp\/v2\/media\/4751"}],"wp:attachment":[{"href":"https:\/\/ifssoecbackup.ypo.pw\/api\/wp\/v2\/media?parent=4749"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}