Treatment of Morbid Obesity

The conventional way to treat morbid obesity via bariatric surgery has changed as medicine has evolved over the years. In 1973, Dr. Ward Griffen first performed an open gastric bypass surgery utilizing a modified version of the Roux-en-Y gastrojejunostomy (Smith et al., 2004). This procedure created a 50 mL gastric pouch that had a Roux-limb (Smith et al., 2004). However, in 1999 the medical world changed again when a laparoscopic version of the Roux-en-Y surgery was adopted after Drs. Wittgrove and Clark performed the first one (Smith et al., 2004). Today, the conventional and most commonly preformed bariatric surgery is the laparoscopic Roux-en-Y gastric bypass; this method is favored over an open route. In 2005 alone, Weller and Rosati found that over 75% of gastric bypass surgeries performed that year were laparoscopic surgeries (Banka et al., 2012). According to Suter et al, the laparoscopic option is becoming more appealing due to its lower postoperative complications and quicker recovery time as compared to open gastric bypass surgery (2003). In addition to having a quicker recovery time, laparoscopic surgery tends to result in shorter hospital stays and less blood loss during surgery (Siddiqui et al., 2006). Although the Roux-en-Y gastric bypass procedure is a fairly complicated procedure, skilled surgeons can accomplish the surgery with little-to-no mortality.

The typical laparoscopic Roux-en-Y gastric bypass surgery technique is described as follows. However, there are many variations and many preferences are left up to surgeon’s choice, such as the type of stapler used for the gastrojejunostomy (circular vs. linear). There are three main steps in the Roux-en-Y bariatric surgery: creation of the gastric pouch, creatio...

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..., S., Hamad, G., Ramanathan, R., & Gourash, W. (2003). Laparoscopic gastric bypass surgery: Current technique. Journal of Laparoendoscopic & Advanced Surgical Techniques, 13(4).

Shikora, S. A. (2012). Laproscopic bi-directional jejuno-jejunostomy anastomosis with a linear stapler. Bariatric Times, 9(6), 8-9.

Siddiqui, A., Livingston, E., & Huerta, S. (2006). A comparison of open and laparoscopic Roux-en-Y gastric bypass surgery for morbid and super obesity: a decision-analysis model. American Journal of Surgery, 192.

Smith, S. C., Edwards, C. B., Goodman, G. N., Halversen, R. C., & Simper, S. C. (2004). Open vs laparoscopic Roux-en-Y gastric bypass: Comparison of operative morbidity and mortality. Obesity Surgery, 14, 73-76.

Suter, M., Giusti, V., Heraief, E., Zysset, F., & Calmes, J. M. (2003). Laparoscopic Roux-en-Y gastric bypass. Surgical Endoscopy, 17, 603-609.