History of Gastric Bypass Surgery

Weight loss (Gastric Bypass Surgery) surgery is a unique field, in that with one operation, a person can be potentially cured of numerous medical diseases including diabetes, hypertension, high cholesterol, sleep apnea, chronic headaches, venous stasis disease, urinary incontinence, liver disease, and arthritis. Gastric Bypass Surgery is the only proven method that results in durable weight loss. This proven surgical approach, combined with the dismal failure of dieting, the marked improvement in quality of life and the quick recovery with minimally invasive techniques, has fueled the surge in the number of Gastric bypass procedures performed annually over the last 10 years.

The first operations designed solely for the purpose of weight loss were initially performed inthe 1950s at the University of Minnesota. The jejunoileal bypass (JIB) induced a state of malabsorption by bypassing most of the intestines while keeping the stomach intact. Although the weight loss with the JIB was good, too many patients developed complications such as diarrhea, night blindness (from vitamin A deficiency), osteoporosis (from vitamin D deficiency), proteincalorie
malnutrition, and kidney stones. Some of the most worrisome complications were associated with the toxic overgrowth of bacteria in the bypassed intestine. These bacteria then caused liver failure, severe arthritis, skin problems, and flulike symptoms. Consequently, many patients have required reversal of the procedure, and the procedure has been abandoned.

This led to a search for better operations.

Modifications in the original procedures and the development of new techniques have led to 3 basic concepts for Gastric Bypass Surgery, as follows:

• Gastric restriction by gastric banding (verticalbanded gastroplasty and adjustable banding)
• Gastric restriction with mild malabsorption (Roux-en-Y gastric bypass)
• A combination of mild gastric restriction and malabsorption (duodenal switch)