Overview of Bariatric Operations

  • Daniel E. Swartz
  • Edward L. Felix

Overweight, obesity, and morbid obesity, defined as body mass indices greater than or equal to 25, 30, and 40 kg/m2, respectively, constitute a burgeoning global epidemic. Approximately 30% of Americans are obese, of whom over 5 million suffer from morbid obesity. For the latter cohort, bariatric surgery is the only effective means to achieve significant weight loss with improvement or resolution of comorbid diseases. The field of bariatric surgery began over 50 years ago and has grown steadily and, over the last decade, explosively, with over 100,000 procedures performed annually in the United States.

The purpose of this chapter is to present the reader with a framework for understanding the numerous described bariatric surgical procedures along with their historical development. The evolution of these operations has not been a linear process, as previously abandoned procedures have been modified and reintroduced. As newer technologies emerge, this framework will permit the reader to compare their function, advantages, and limits of use to existing procedures.


Bariatric Operation Gastric Bypass Morbid Obesity Sleeve Gastrectomy Laparoscopic Adjustable Gastric Banding 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

Selected Reference

  1. Belachew M, Legrand M, Vincent V, et al. Laparoscopic adjustable gastric banding. World J Surg 1998;22:955–963PubMedCrossRefGoogle Scholar
  2. Bo O, Modalsli O. Gastric banding, a surgical method of treating morbid obesity: preliminary report. In J Obes 1983;7:493–499Google Scholar
  3. Brolin RE, Kenler HA, Gorman JG, et al. Long-limb gastric bypass in the superobese: a prospective randomized study. Ann Surg 1992;215:387–395PubMedCrossRefGoogle Scholar
  4. Brolin RE, Kowalski C. Operations for morbid obesity. In: Yeo CJ, Dempsey DT, Klein AS, et al. editors. Shackleford’s surgery of the alimentary tract, 6th ed. Philadelphia: Saunders/Elsevier, 2007:928–939Google Scholar
  5. Cigaina V, Pinato G, Rigo V, et al. Gastric peristalsis control by mono situ electrical stimulation: a preliminary study. Obes Surg 1996;6:247–249PubMedCrossRefGoogle Scholar
  6. De Csepel J, Quinn T, Pomp A, et al. Conversion to a laparoscopic biliopancreatic diversion with a duodenal switch for failed laparoscopic adjustable silicone gastric banding. J Laparoendosc Adv Surg Tech A 220;12:237–240CrossRefGoogle Scholar
  7. DeMeester TR, Fuchs KH, Ball CS, et al. Experimental and clinical results with proximal end-to-end duodenojejunostomy for pathologic duodenogastric reflux. Ann Surg 1987;205:414–426Google Scholar
  8. Doherty C. Vertical banded gastroplasty. Surg Clin N Am 2001;81:1097–1112PubMedCrossRefGoogle Scholar
  9. Griffen WO, Young VL, Stevenson CC. A prospective comparison of gastric and jejunoileal bypass operation for morbid obesity. Ann Surg 1977;186:500–507PubMedCrossRefGoogle Scholar
  10. Gumbs AA, Gagner M, Dakin G, et al. Sleeve gastrectomy for morbid obesity. Obes Surg 2007;17:962–969PubMedCrossRefGoogle Scholar
  11. Hess DS, Hess DW. Biliopancreatic diversion with duodenal switch. Obes Surg 1988;8:267–282CrossRefGoogle Scholar
  12. Keshishian A, Zahriya K, Hartoonian T, et al. Duodenal switch is a safe operation for patients who have failed other bariatric operations. Obes Surg 2004;14:1187–1192PubMedCrossRefGoogle Scholar
  13. Kremen AJ, Linner LH, Nelson CH. An experimental evaluation of the nutritional importance of proximal and distal small intestine. Ann Surg 1954;140:439–448PubMedCrossRefGoogle Scholar
  14. Kuzmak LI. Surgery for morbid obesity. Using an inflatable gastric band. AORN J1990;51:1307–1324PubMedCrossRefGoogle Scholar
  15. MacLean LD, Rhode BM, Sampalis J, et al. Results of the surgical treatment of obesity.Am J Surg 1993;165:155–162PubMedCrossRefGoogle Scholar
  16. Marceau P, Hould FS, Simard S, et al. Biliopancreatic diversion with duodenal switch.World J Surg 1998;22:947–954PubMedCrossRefGoogle Scholar
  17. Marinari GM, Murelli F, Camarini G, et al. A 15-year evaluation of biliopancreatic diversionaccording to the Bariatric Analysis Reporting Outcome System (BAROS). ObesSurg 2004;14:325–328PubMedCrossRefGoogle Scholar
  18. Mason EE. Vertical banded gastroplasty for obesity. Arch Surg 1982;117:701–706PubMedGoogle Scholar
  19. Mason EE. Why the operation I prefer is the vertical banded gastroplasty 5.0. Obes Surg1991;1:181–183PubMedCrossRefGoogle Scholar
  20. Mason EE, Ito C. Gastric bypass in obesity. Surg Clin N Am 1967;47:1345–1351PubMedGoogle Scholar
  21. O’Brien PE, Dixon JB. Laparoscopic adjustable gastric banding in the treatment of morbidobesity. Arch Surg 2003;138:376–382PubMedCrossRefGoogle Scholar
  22. Poiries WJ, Swanson MS, MacDonald KG, et al. Who would have thought it? An operationproves to be the most effective therapy for adult-onset diabetes mellitus. AnnSurg 1995;222:339–350CrossRefGoogle Scholar
  23. Regan JP, Inabnet WB, Gagner M, et al. Early experience with two-stage laparoscopicRoux-en-Y gastric bypass as an alternative in the super-super obese patient. ObesSurg 2003;13:861–864PubMedCrossRefGoogle Scholar
  24. Schauer P. Gastric bypass for severe obesity: approaches and outcomes. Surg Obes RelDis 2005;1:297–300CrossRefGoogle Scholar
  25. Scopinaro N, Adami GF, Mariari GM, et al. Biliopancreatic diversion. World J Surg1998;22:936–946PubMedCrossRefGoogle Scholar
  26. Scopinaro N, Gianetta E, Civalleri D. Biliopancreatic bypass for obesity: II. Initial experiencein man. Br J Surg 1979;66:618–620PubMedCrossRefGoogle Scholar
  27. Slater GH, Fielding GA. Combining laparoscopic adjustable gastric banding and biliopancreaticdiversion after failed bariatric surgery. Obes Surg 2004;14:677–682PubMedCrossRefGoogle Scholar
  28. Torres JC, Oca CF, Garrison RN. Gastric bypass: Roux-en-Y gastrojejunostomy from thelesser curvature. South Med J 1983;76:1217–1221PubMedGoogle Scholar
  29. Wilkinson LH, Peoloso OA. Gastric (reservoir) reduction for morbid obesity. Arch Surg1981;116:602–605PubMedGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC 2008

Authors and Affiliations

  • Daniel E. Swartz
    • 1
  • Edward L. Felix
    • 2
  1. 1.Department of Surgery, Bariatric ProgramSaint Agnes Medical CenterFresno
  2. 2.Advanced Bariatric Center, Assistant Clinical ProfessorUCSF-Fresno, Director of Bariatric Surgery, Clovis Community Medical CenterFresno

Personalised recommendations