The optimal surgical management of the super-obese patient: the debate. Presented at the annual meeting of the Society of American Gastrointestinal and Endoscopic Surgeons, Hollywood, Florida, USA, April 13-16, 2005

DeMaria, Eric J.; Schauer, Philip; Patterson, Emma; Nguyen, Ninh T.; Jacob, Brian P.; Inabnet, William B.; Buchwald, Henry
June 2005
Surgical Innovation;Jun2005, Vol. 12 Issue 2, p107
Academic Journal
journal article
Optimal management of the super-obese patient (body mass index>50 kg/m2) undergoing weight loss surgery in the new era of laparoscopic treatment is more controversial than ever before. Newer laparoscopic options for treatment of the super obese, including laparoscopic adjustable gastric banding, sleeve gastrectomy, and staging of gastric bypass, are technically easier and may be safer. Concerns that weight loss may be suboptimal or that the procedures will require revision, or both, make these choices controversial. Open access/conversion for established procedures such as long-limb gastric bypass and biliopancreatic diversion with or without duodenal switch are the traditional alternatives when laparoscopic access fails or is deemed too difficult to undertake. The following debate was presented by invited experts in laparoscopic and open bariatric surgery at the 2005 Annual Meeting of the Society of American Gastrointestinal and Endoscopic Surgeons in Florida. The presenters put forth arguments for the various modern options for treatment of the super obese, which are presented in written form. Interactive audience response technology provided a mechanism for polling the audience before and after the presentations. A review of the audience's responses provides insight into the decision-making considerations of a population of laparoscopically oriented bariatric surgeons.


Related Articles

  • Laparoscopic Sleeve Gastrectomy for Late Adolescent Population. Nocca, David; Nedelcu, Marius; Nedelcu, Anamaria; Noel, Patrick; Leger, Phillipe; Skalli, Mehdi; Lefebvre, Patrick; Coisel, Yannael; Laurent, Caroline; Lemaitre, Frederic; Fabre, Jean // Obesity Surgery;Jun2014, Vol. 24 Issue 6, p861 

    Background: Morbid obesity prevalence is rapidly increasing among adolescents worldwide. Evidence is mounting that bariatric surgery is the only reliable method for substantial and sustainable weight loss; however, the debate continues with regard to the optimal surgical procedure for...

  • Sleeve gastrectomy: radiologic patterns after surgery. Goitein, David; Goitein, Orly; Feigin, Anya; Zippel, Douglas; Papa, Moshe // Surgical Endoscopy;Jul2009, Vol. 23 Issue 7, p1559 

    Laparoscopic sleeve gastrectomy (LSG) is gaining popularity as an additional bariatric procedure, either as a first step for biliopancreatic diversion or gastric bypass or as a stand-alone option for selected patients. Early postoperative fluid tolerance varies between patients and influences...

  • Comparative analysis of laparoscopic sleeve gastrectomy and laparoscopic Roux-en-Y gastric bypass applied in the surgical treatment of morbid obesity. Erol, Varlık; Yılmaz, Tuğba Han; Gülay, Hüseyin // Journal of Surgical Arts / Cerrahi Sanatlar Dergisi;2016, Vol. 9 Issue 2, p52 

    In this study, it was aimed to determine the efficacy of laparoscopic sleeve gastrectomy (LSG) and laparoscopic Roux-en-Y Gastric Bypass (RYGB) applied in patients diagnosed with morbid obesity in weight loss and the treatment of comorbid diseases. Between September 2014-September 2015 16...

  • Prophylactic cholecystectomy, a mandatory step in morbidly obese patients undergoing laparoscopic Roux-en-Y gastric bypass? D'Hondt, Mathieu; Sergeant, Gregory; Deylgat, Bert; Devriendt, Dirk; Rooy, Frank; Vansteenkiste, Franky; Van Rooy, Frank // Journal of Gastrointestinal Surgery;Sep2011, Vol. 15 Issue 9, p1532 

    Background: The aim of this study was to determine the incidence of symptomatic gallstone disease requiring cholecystectomy (CCE) after laparoscopic Roux-en-Y gastric bypass (LRYGBP) and to identify the peri-operative risk factors associated with postoperative symptomatic gallstone...

  • Results of Teenaged Bariatric Patients Performed in an Adult Program. Madan, Atul K.; Dickson, Paxton V.; Ternovits, Craig A.; Tichansky, David S.; Lobe, Thom E. // Journal of Laparoendoscopic & Advanced Surgical Techniques;Aug2007, Vol. 17 Issue 4, p473 

    Background: Morbid obesity is a growing epidemic among adolescents. Bariatric surgery has proven to be the only long-term effective method in treating morbidly obese adults for over a decade. The laparoscopic approach has become a popular option. This study tested the hypothesis that...

  • Changes in Lipid Profiles in Morbidly Obese Patients After Laparoscopic Sleeve Gastrectomy (LSG). Feng Zhang; Strain, Gladys Witt; Wen Lei; Dakin, Gregory F.; Gagner, Michel; Pomp, Alfons // Obesity Surgery;Mar2011, Vol. 21 Issue 3, p305 

    Background: Laparoscopic sleeve gastrectomy (LSG) has evolved as a primary weight loss surgery. This study provides changes in lipid profiles in obese patients 1 year after LSG. Methods: A retrospective analysis of patients who underwent LSG from June 2004 to June 2008 provided data on...

  • Weight Loss after Sleeve Gastrectomy in Super Superobesity. Catheline, J.-M.; Fysekidis, M.; Dbouk, R.; Boschetto, A.; Bihan, H.; Reach, G.; Cohen, R. // Journal of Obesity;2012, Vol. 2012, p1 

    Objective. This prospective study evaluated laparoscopic sleeve gastrectomy for its safety and efficiency in excess weight loss (%EWL) in super superobese patients (BMI > 60 Kg/m2). Results. Thirty patients (33 women and 7 men) were included, with mean age of 35 years (range 18 to 59).Mean...

  • Laparoscopic Gastric Bypass for Morbid Obesity Decreases Bodily Pain, Improves Physical Functioning, and Mental and General Health in Women. Frezza, Eldo E.; Shebani, Khaled O.; Wachtel, Mitchell S. // Journal of Laparoendoscopic & Advanced Surgical Techniques;Aug2007, Vol. 17 Issue 4, p440 

    Introduction: Surgery is an effective long-term therapeutic option for morbid obese patients. Although bariatric surgery's amelioration of medical ailments is well established, its nonphysical benefits have not been as well documented. Methods: Women who had undergone laparoscopic gastric bypass...

  • Early U.S. outcomes of laparoscopic gastric bypass versus laparoscopic adjustable silicone gastric banding for morbid obesity. Kim, T. H.; Daud, A.; Ude, A. O.; DiGiorgi, M.; Olivero-Rivera, L.; Schrope, B.; Davis, D.; Inabnet, W. B.; Bessler, M. // Surgical Endoscopy;Feb2006, Vol. 20 Issue 2, p202 

    Laparoscopic gastric bypass (LGBP) is the gold standard operation for long-term weight control in the United States. Laparoscopic adjustable silicone gastric banding (LASGB) is the preferred operative method for morbid obesity worldwide. Limited data are available comparing the two procedure in...

  • Robot-assisted gastrojejunal anastomosis does not improve the results of the laparoscopic Roux-en-Y gastric bypass. Scozzari, Gitana; Rebecchi, Fabrizio; Millo, Paolo; Rocchietto, Stefano; Allieta, Rosaldo; Morino, Mario // Surgical Endoscopy;Feb2011, Vol. 25 Issue 2, p597 

    Background: Traditional laparoscopic surgery presents some difficulties for morbidly obese patients due to limited motion of instruments related to a thick abdominal wall, intraabdominal fat, and a large hepatic left lobe, with consequent loss of dexterity and greater musculoskeletal discomfort....


Read the Article


Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics