History of bariatric surgery

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foregutsurgeon

Health & Medicine

The History of Bariatric Surgery

Abeezar I. Sarela
Consultant in Upper GI & Bariatric Surgery
St James’s University Hospital, Leeds

10,000 cases since Dec 2008

Estimated need for England: 1,40,000

End-to-end jejunoileostomy with
ileo-caecostomy
1953: Varco, University of Minnesota
1954: Kremen, Linner & Nelson: University of Minnesota

End-to-side
jejuno-transverse colostomy
1963- Payne & DeWind

End-to-side jejunoileostomy

1965 - Sherman

End-to-side jejuno-caecostomy

1966 – Lewis, Turnbull & Page

Classic
“14 + 4” end-to-side jejunoileostomy

1969 – Payne & DeWind

End-to-end jejunoileostomy
with ileo-sigmoidostomy

1971 – Scott

End-to-side jejuno-ileostomy
with an anti-reflux valve or plication

1977 – Forestieri
1978 - Starkloff

End-to-end jejuno-ileostomy
with ileo-gastrostomy
1988 – Cleator & Courlay

Bilio-Intestinal bypass
1978 – Lavorato
1981 - Eriksson

Bilio-Pancreatic Diversion
1979 - Scopinaro

Duodenal switch
with cross-stapling of the duodenum
1993 - Marceau

Duodenal switch
with division of the duodenum

1998 – Hess & Hess

Gastric transection
with loop gastrojejunostomy
1967 – Mason & Ito, Iowa

Horizontal gastric stapling with loop
gastrojejunostomy
1977 - Alden

Horizontal gastric stapling with
Roux-en-Y gastrojejunostomy

1977 - Griffen

Vertical gastric stapling with
Roux-en-Y gastrojejunostomy
1983 – Torres, Oca & Garrison

The Magenstrasse & Mill Operation

David Johnston

Vertical gastric stapling with
Roux-en-Y gastrojejunostomy with
long bilio-pancreatic limb
1987 – Torres & Oca

Vertical gastric division with interposed
Roux-en-Y gastrojejunostomy and
proximal silastic ring
1991- Fobi

Laparoscopic Roux-en-Y gastric
bypass
1994 – Wittgrove and Clark

Partial gastric transection, greater
curve conduit
1971 – Mason & Printen

Horizontal gastric stapling,
greater curve conduit
1979 - Gomez

Gastric partitioning
1979 – Pace & Carey

Total horizontal gastric stapling with
gastrogastrostomy
1979 – LaFave & Alden

Gastroplasty: Vertical stapling
1981: Fabito

Silastic ring vertical gastroplasty
1981 - Laws

Vertical Banded Gastroplasty

1982 - Mason

Gastric Band

1978 – Wilkinson
1982 – Kolle
1983 - Molina

Adjustable Silastic Gastric Band

1986 - Kuzmak

Laparoscopic adjustable gastric band

1993 - Forsell

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Acute colonic pseudo obstruction is an abdominal emergency seen in elderly hospitalised patients being treated for major orthopaedic or medical ailments. It has to be differentiated from mechanical obstruction. Identifying and treating medical and metabolic derangements is the first line of treatment. If the patient does not respond then prokinetic medications such as neostigmine should be administered. Colonoscopic decompression and finally surgical intervention are indicated in cases resistant to treatment. The morbidity and mortality associated with these modalities is quite high.

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The surgical treatment of an injury or defect within the urethra's walls is known as urethroplasty. The three most frequent factors leading to urethral damage that needs to be repaired are trauma, iatrogenic injury, and infections. The gold standard treatment for urethral strictures is urethroplasty, which has a lower recurrence rate than dilatations and urethrotomies. Although recurrence rates are higher for this challenging treatment group, it is likely the only effective treatment option for chronic and severe strictures. Urethroplasty is not regarded as a small procedure, taking three to eight hours on average in the operating room. Between 20% and 30% of urethroplasty patients may benefit from the ease of going under the knife for a shorter period of time and going home the same day. On average, hospital stays last two to three days. Seven to ten days may be needed for hospitalization for more complicated surgeries. Fewer than ten percent of patients experience significant complications after urethroplasty, while complications, particularly recurrences, are more frequent in long and complex strictures.

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25 yrs old patient took sulphos accidentally 9 months back and developed stricture and tracheoesophageal fistula just above the Carina.He was treated with a covered self expanding metallic esophageal stent (SEMS).His pneumonia improved but fistula did not close and he started having disphagia (difficulty in swallowing).He was taken up for surgery. Esophagectomy stent removal & closure of tracheal defect and gastric pull up forming neo esophagus was done.

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