Puget Sound Surgical Center - The History of Weight Loss Surgery - Seattle Weight Loss Surgery and Bariatric Experts


	The History of Bariatric Surgery GASTRIC BYPASS Gastric Bypass (RGB) was developed by Dr Edward E. Mason, of the University of Iowa in the 1960's, based on the weight loss observed among patients undergoing partial stomach removal for ulcers. Over several decades, the gastric bypass has been modified into its current form, using a Roux-en-Y limb of intestine (RYGBP). The RYGBP is the most commonly performed operation for weight loss in the United States. In the U.S, approximately 140,000 gastric bypass procedures will be performed in 2005, far outnumbering the LAP-BAND®, duodenal switch, and vertical banded gastroplasty procedures. Initially the operation was performed as a loop bypass with a much larger stomach. Because of bile reflux that occurred with the loop configuration, the operation is now performed as a “Roux-en-Y” with a limb of intestine connected to a very small stomach pouch which prevents the bile from entering the upper part of the stomach and esophagus. The remaining stomach and first segment of small intestine are bypassed. In the standard RYGBP, the amount of intestine bypassed is not enough to create malabsorption of protein or other macronutrients. However, because the bypassed portion of intestine is where the majority of calcium and iron absorption takes place, anemia and osteoporosis are the most common long-term complications of the RYGBP. Therefore, lifelong mineral supplementation is mandatory. Lifelong follow-up with a bariatric program and daily multi-vitamins are strongly recommended prevent nutritional complications. Half of the weight loss often occurs during the first six months after surgery; weight loss usually peaks at 18-24 months. The obesity-related comorbidities that may be improved or cured with the RYGBP include adult onset type diabetese, hypertension, high cholesterol, arthritis, venous stasis disease, bladder incontinence, liver disease, certain types of headaches, heartburn, sleep apnea and many other disorders. Furthermore, the RYGBP has resulted in marked improvements in quality of life. After surgery, patients often experience marked changes in their behavior. Most patients have a reduction in hunger and feel full sooner after eating. Patients often state that they enjoy healthy foods and lose many of their improper food cravings. Rarely do people feel deprived of food. Another mechanism for weight loss after the RYGBP is referred to as the dumping syndrome. Dumping may result in lightheadedness, flushing, heart palpitations, diarrhea and other symptoms early (within 10 to 30 minutes) after eating sweets or foods with a high concentration of sugar. Some people remain extremely sensitive to sweets for the rest of their lives; most patients lose some or all of their sweets sensitivity over time. History continued

GASTRIC BYPASS

Gastric Bypass (RGB) was developed by Dr Edward E. Mason, of the University of Iowa in the 1960's, based on the weight loss observed among patients undergoing partial stomach removal for ulcers. Over several decades, the gastric bypass has been modified into its current form, using a Roux-en-Y limb of intestine (RYGBP). The RYGBP is the most commonly performed operation for weight loss in the United States. In the U.S, approximately 140,000 gastric bypass procedures will be performed in 2005, far outnumbering the LAP-BAND®, duodenal switch, and vertical banded gastroplasty procedures.

Initially the operation was performed as a loop bypass with a much larger stomach. Because of bile reflux that occurred with the loop configuration, the operation is now performed as a “Roux-en-Y” with a limb of intestine connected to a very small stomach pouch which prevents the bile from entering the upper part of the stomach and esophagus.

The remaining stomach and first segment of small intestine are bypassed. In the standard RYGBP, the amount of intestine bypassed is not enough to create malabsorption of protein or other macronutrients. However, because the bypassed portion of intestine is where the majority of calcium and iron absorption takes place, anemia and osteoporosis are the most common long-term complications of the RYGBP. Therefore, lifelong mineral supplementation is mandatory. Lifelong follow-up with a bariatric program and daily multi-vitamins are strongly recommended prevent nutritional complications.

Half of the weight loss often occurs during the first six months after surgery; weight loss usually peaks at 18-24 months. The obesity-related comorbidities that may be improved or cured with the RYGBP include adult onset type diabetese, hypertension, high cholesterol, arthritis, venous stasis disease, bladder incontinence, liver disease, certain types of headaches, heartburn, sleep apnea and many other disorders. Furthermore, the RYGBP has resulted in marked improvements in quality of life.

After surgery, patients often experience marked changes in their behavior. Most patients have a reduction in hunger and feel full sooner after eating. Patients often state that they enjoy healthy foods and lose many of their improper food cravings. Rarely do people feel deprived of food. Another mechanism for weight loss after the RYGBP is referred to as the dumping syndrome. Dumping may result in lightheadedness, flushing, heart palpitations, diarrhea and other symptoms early (within 10 to 30 minutes) after eating sweets or foods with a high concentration of sugar. Some people remain extremely sensitive to sweets for the rest of their lives; most patients lose some or all of their sweets sensitivity over time.

History continued