Today, morbid obesity surgery is the fastest growing branch in general surgery world wide.
Types of morbid obesity operations:
The modern morbid obesity surgery started in the United States in 1980 with the VBG operation (Vertical banded gastroplasty, or commonly known as Stomach stapling). The operation was devised by Ed Mason (Iowa, US), who is considered the god father of modern obesity surgery. Also at the same time the biliopancreatic diversion operation was developed by Nicola Scopinaro (Genoa, Italy). The stomach stapling operation became very popular and 400,000 cases have been performed to date. The Gastric or stomach bypass operation became very popular in the mid eighties in the US and has steadily grown till now where it has become the gold standard of all obesity operations especially after the operation was performed laparoscopically in 1993 by Allen Wittgrove in San Diego.. The adjustable stomach banding operation appeared in the mid nineties and it became popular in Australia and Europe but to date it has not gained big popularity in the US. The nineties was also the period where the technique of performing all the stomach obesity operations was changed to laparoscopy (4-6 small incisions, no pain, 1 day in hospital, rapid return to normal activity. A total of 1.1 million morbid obesity surgeries were performed world wide since 1980, mostly performed in the USA. Every operation has a different mechanism of action and the patient needs to be compliant with the follow up after surgeries have been performed. The obesity surgeon should be capable of performing all types of obesity procedures so that he will choose the best procedure for the patient. Laparoscopy (performing the operation through few tiny (0.5-1 cm) incisions) presented a giant step forward for these patients with better patient comfort and tolerability. All types of morbid obesity operations are now performed laparoscopically with 1-2 days` hospital stay. Patients start to gradually lose the excess weight and this is associated with cure from the obesity induced diseases.
So, What is the best obesity operation?
The best approach is that the surgeon becomes familiar with all 4 types to give the patient an unbiased opinion as to which operation is best for him on the short and long term. Being capable of performing all 4 types laparoscopically can eliminate the patient`s inclination to a specific procedure because it is done with the scope.