History of the development of bariatric surgery

Ноя 21, 2015

The term " bariatrics " (from the Greek . Baro - weight ) appeared in the medical literature in the middle of the last century and is a branch of medicine that studies the causes , prevention and treatment of obesity. To date, bariatric surgery is not uncommon. It's quite common and effective way to combat obesity , which allows to achieve a significant reduction in body weight , even in cases when all other approaches are inconclusive .

In the 50- ies of XX century was made first skinny - iliac artery bypass surgery , during which of digestion was off almost the entire small intestine. It is a surgical procedure and became the prototype of all subsequent operational procedures which are based on the effect of the development of malabsorption , ie deterioration of digestion and reduce nutrient absorption . The process of weight loss in such cases stops when it reaches a balance between calorie intake and expenditure , which is the normal adaptive ( adaptive ) function of the digestive system.

After a decade in the surgical treatment of obesity there has been a new trend - operations that cause malabsorption and with it, limiting the scope of the stomach ( gastric bypass ) . And the payment was originally that weight loss will be exactly due to the latter.

Although the minimum number of long-term complications after such interventions led to their superiority over skinny - iliac bypass , paired with a high risk of dyspeptic disorders ( bloating , diarrhea) , electrolyte imbalance , hepatic fibrosis , kidney stones , skin rashes, but they also have their disadvantages and fraught with the development of iron deficiency anemia and vitamin B12 malabsorption .

In addition, the operation of this type do technically impossible diagnostic inspection disconnected parts of the digestive tube. Particularly popular gastric bypass acquired in the 1970s - early 1980s . However, on the previous version , calling purely malabsorption , not completely forgotten, just as it would be pushed into the background. Information on such transactions ( biliopankreaticheskoe , biliointestinalnoe bypass) periodically surfaced in the scientific medical literature in the period up to 90 years of the last century.

In particular , when it became possible to prevent or at least minimize the complications of the vast amount by forming enteric two functional loops in the distal merged into a common channel that virtually eliminates the possibility of stagnation of bowel contents , and hence the excessive reproduction of bacteria such operations are taken back its right to exist .

In the same period there were purely restrictive , ie reducing the amount of stomach or narrowing of the lumen surgery banded gastroplasty by type , dividing the stomach , etc. , through which equipment bariatric surgeries was significantly simplified. But most important , it is literally revolutionary step in the development of bariatric surgery has been the widespread introduction of laparoscopic techniques , which began in the mid -1990s , which made ​​it possible to abandon the open traumatic interventions to improve the prognosis and greatly facilitate the rehabilitation period.

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