Surgical treatment of morbid obesity

Overview

Obesity is the most frequent multifactorially determined metabolic disorder. According toWHOreports the increasing prevalence of obesity (Body Mass Index>30) has a rising trend not onlyin the industrialized countries but of late also in a number of developing countries. Second tosmoking, obesity represents another most frequent cause of death which can be prevented. Theprimary option in treating morbidly obese patients is a conservative approach under theguidance of an obesitologist. Morbidly obese patients (BMI>40) on failure of other therapeuticmethods and in relapses of overweight, are indicated for surgical treatment of obesity.Presently,there are applied in a standard fashion bariatric methods such as gastric bypass, biliopancreaticdiversion or its newer modification, duodeno-jejunal shunt. Further, there are interventionsperformed solely on the stomach of the vertical bandage type of gastric plastic surgery, or gastricbandageing.Gastric bandageings (GB) have been applied in the treatment of obesity with excellent resultsfor more than 20 years already. In the years 1993 through 2002, at the First Department ofSurgery, University General Hospital and the 1st Faculty of Medicine, Charles University inPrague, there have in all been carried out 657 surgical interventions for morbid obesity, i.e. in608 (93 %) obese patients non-adjustable gastric bandageing (NGB) and in 49 (7 %) adjustablebandageing (AGB). Two years after GB there was an average decrease in weight of -39.7 kg andan average reduction of BMI over the same period by -13.8 kg/m2.

Key words:
obesity - morbid obesity - surgical treatment - gastric bandageing - plastic surgery.