History
The first surgical attempts
to cause weight loss were
carried out during the 1950s.
These procedures evolved
out of observations made
by surgeons performing gastric
(stomach) surgery for ulcer
disease. It was noted that
patients who had undergone
removal of a part of the
lower stomach (called "distal
gastrectomy") often lost
significant amounts of weight,
and kept it off. Modifications
of the ulcer operations
were made (at the University
of Iowa), leading to performance
of a variant procedure expressly
designed as a treatment
for obesity, (1969). Although
modifications have been
made to this original procedure,
the gastric bypass of today
involves largely the same
operative design.
The majority of weight
loss procedures performed
for many years were accomplished
through a large, long incision
in the center of the abdomen.
This caused significant
post-operative pain, lengthy
recovery and objectionable
scarring. Soon, however,
"laparoscopic" techniques
first used for gallbladder
removal were borrowed for
use in gastric surgery.
In laparoscopic procedures,
the patient's abdomen is
filled with carbon dioxide
to distend it after which
instruments and a video
camera are introduced via
small tubes called
"ports." The surgeon
and assistant introduce
instruments through the
small ports and are able
to visualize what they are
doing by viewing the internal
anatomy on a monitor
connected to their video
camera. Gastric bypass procedures
performed through laparoscopic
technique have been shown
to be just as effective
in producing weight loss
as the earlier, "open" procedures,
but with quicker recovery
and fewer complications. |
