Believe it or not, bariatric surgery dates back to 10th-century Spain, and one of the earliest accounts involved a king named Sancho of Leon. He allegedly was so obese he was no longer able to walk, ride a horse, or wield a sword, so he lost his throne. His grandmother took him to Cordoba to seek help from the renowned physician Hasdai Ibn Shaprut, who performed a weight loss surgery by suturing the king’s lips together so he could only eat a liquid diet through a straw. Along with this drastic surgery, the king used a mixture of herbs containing opium, which resulted in him losing half of his weight. King Sancho regained his mobility and was able to go back to his land and reclaim his throne. Thankfully, the new weight loss surgery performed these days is significantly safer, more effective, and medically sound.
Today we are going to review a brief history of bariatric procedures from the oldest to the newest weight loss surgery. We will talk about some of their pros and cons and provide some information about a fairly new bariatric surgery field called endobariatrics that is significantly less invasive, reversible, and offers amazing weight loss potential.
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A Brief History Of Bariatric Surgery
Gastric Bypass Surgery (Roux-en-Y)
Dr. Mason was a surgeon at the University of Iowa when he observed that patients who had undergone partial gastrectomies for cancer experienced significant weight loss as a side effect. This inspired him to develop and perform the first open gastric bypass surgery in 1966, designed specifically to help individuals with obesity lose weight. Initially, the procedure was done by dividing the stomach horizontally and creating a loop ileostomy. Over the next several years it has been refined a few times to help mitigate chronic side effects like acid reflux, but Dr. Mason stayed involved with these improvements, and he developed the Roux-en-Y gastric bypass technique that is performed today.
In 1994 the first laparoscopic gastric bypass surgery was performed by Dr. Alan Wittgrove, which made it safer and improved the recovery time, which greatly increased its popularity. By 2011, an estimated 340,000 individuals had undergone laparoscopic gastric bypass surgery worldwide. Modern gastric bypass surgery today involves Dr. Mason’s Roux-en-Y technique and Dr. Wittgrove’s less invasive laparoscopic technique, as well as minor adjustments made by different surgeons to help improve their patients, results.
Today, gastric bypass surgery involves creating a small pouch from the stomach and connecting it directly to the small intestine, which skips a significant portion of the digestive process. This helps with weight loss because it controls the amount of food the individual can eat at one time and prevents the body from absorbing all the calories from what they consume.
Mini Gastric Bypass Surgery (MGB)
The Mini Gastric Bypass (MGB) was developed by Dr. Rutledge in 1997 in an effort to make gastric bypass surgery simpler and safer. Instead of using the more complex Roux-en-Y gastric bypass technique, in which there are two connections in the intestines, the MGB connects in just one location. The stomach pouch is longer, and the small intestine is rerouted to reduce the amount of food that can be eaten and the absorption of calories.
In the early 2000s laparoscopic mini gastric bypass surgery was introduced as one of the many improvements made to the MGB to resolve issues like bile reflux. Although it has become slightly more popular, the number of standard gastric bypass surgeries still significantly outnumbers them.
Laparoscopic Adjustable Gastric Band
Lubomyr Kuzmak is credited with inventing the first gastric band in 1983, he then designed an adjustable version in 1986 with an inflatable section connected to a small reservoir by a tube. This allowed doctors to adjust the band after surgery and control the individual’s food intake. In June 1986, he received a U.S. patent for his invention and performed the first surgery using it that same month. The adjustable band was more effective than his first nonadjustable version; however, the popularity of adjustable gastric bands has significantly declined due to the lack of long-term weight loss success.
Laparoscopic Duodenal Switch (LDS)
The duodenal switch is the most complex form of bariatric surgery and produces the most significant weight loss results. It was first done in 1998 and is now the least frequently performed weight loss procedure because of the increased risks and potential for malnutrition.
The surgery involves two steps, with the first being removing a large portion of the stomach and the second part involving rerouting the small intestine to limit the amount of calories that can be absorbed during the digestion process. In the early days of this surgery, the two steps were performed during two separate surgeries. The majority of the patient’s stomach was removed, and the remaining edges were fastened together to significantly reduce the amount of food it could hold. Then the patient was given time to heal before the second portion of the surgery was performed. A large number of patients lost so much weight that they no longer needed to follow through with the second part of the surgery. This is now done as gastric sleeve surgery and has been recognized as a standalone procedure since 2007.
Gastric Sleeve aka Laparoscopic Sleeve Gastrectomy (LSG), Vertical Sleeve Gastrectomy (VSG)
This surgery was first designed to be part one of a more complex surgery called duodenal switch and was first performed as a standalone procedure in the early 2000s. Today, it is the most often performed form of bariatric surgery.
During gastric sleeve surgery, the patient’s stomach is reduced by about 75% by cutting away most of the stomach tissue and securing the remaining edges together. This limits the amount of food the individual can eat during one meal and slows down the speed at which their stomach empties. This helps them lose weight by keeping them feeling full for a longer time and reducing their intake of calories.
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Newest Bariatric Surgeries
Single Anastomosis Duodenal Ileal Bypass (SADI)
This surgery was developed in 2007 to obtain benefits and results similar to duodenal switch surgery but using a simpler, less complex technique with fewer complications than traditional duodenal surgery.
In this surgery, a portion of the stomach is removed to create a sleeve, while a segment of the small intestine is bypassed and connected to the distal small bowel. This creates both a restrictive effect by reducing the stomach size and a malabsorptive effect by limiting nutrient absorption. As a result, patients experience significant weight loss while also benefiting from a lower risk of complications such as nutrient deficiencies, which are often seen with traditional duodenal switch surgeries.
Single Anastomosis Sleeve Ileal Bypass (SASI)
This is a fairly new weight loss surgery that was developed in 2010 and is a combination of a gastric sleeve with a bypass of the small intestine. It provides significant weight loss potential and offers increased metabolic benefits with fewer complications, like nutritional deficiencies, than traditional bypass surgeries.
During the procedure, the stomach is reduced to a small sleeve to limit food intake, while a portion of the small intestine is bypassed to minimize nutrient absorption.
What Is Better Than The Newest Weight Loss Surgery?
Bariatric surgery is known for its effectiveness in helping individuals struggling with obesity achieve significant weight loss. Interestingly, only about 1% of people who qualify for bariatric surgery actually proceed with it. There are many reasons for their decision, such as they are concerned about undergoing surgery, they are not healthy enough to undergo surgery, or their responsibilities do not allow the necessary recovery time.
Today, there is a new, innovative, and minimally invasive option called Suture Sculpt Endoscopic Sleeve Gastroplasty (ESG) that offers similar results to gastric sleeve surgery without the need for incisions or a lengthy recovery. It is performed entirely through the mouth using an endoscope, which is a flexible medical instrument that is equipped with a camera and allows the doctor to use other special tools. During the procedure, the doctor places stitches in the stomach from the inside to create a smaller, sleeve-like shape. This limits the amount of food the stomach can hold and helps provide a quick and lasting feeling of fullness so fewer calories are consumed, which helps with weight loss.
Because Suture Sculpt ESG does not involve cutting or removing any part of the stomach, there is a much lower risk of complications compared to traditional surgery. There are virtually no activity restrictions after Suture Sculpt ESG, and patients can resume their normal activities as soon as they feel comfortable doing so. By reducing the stomach’s capacity and making healthier dietary and lifestyle choices, Suture Sculpt ESG offers an amazing alternative to even the newest weight loss surgery available.
Batash Endoscopic Weight Loss Center Offers ESG In NYC
You can find out more about this safe and effective procedure for weight loss by setting up a consultation with the experts at Batash Endoscopic Weight Loss Center in NYC. Dr. Batash is a weight loss expert and has extensive training in obesity medicine. He has over 30 years of experience in helping people from all over the globe become healthier through weight loss. Set up your consultation today!
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