Laparoscopic Bariatric Surgery

Laparoscopic bariatric surgery is intended to be the most effective and least invasive kind of bariatric surgical methods. Known to many as videoscopic surgery, the laparoscopic procedure is an advanced surgical technique often using a video camera to perform operations through very small incisions.

Most operations are performed by making small incisions (usually 1/4 to 1/2 inch) and gently separating the patient’s muscles to enter the abdomen or chest without cutting.  A fiberoptic lighted tube is inserted which transmits an internal picture of the patient onto a television screen for the surgeon and nurses to view.  Small instruments are then inserted and the surgical procedure is completed.

The space-age technology reduces the trauma associated with traditional open surgery.  This can greatly reduce the patient’s pain, hospital stay, recovery time and scarring.

Today, most major abdominal and chest surgeries can be done with laproscopic techniques. 

Surgical therapy should be considered for individuals who:

• have a body mass index (BMI) equal to or greater than 40 kg/m2 OR
• have a BMI equal to or greater than 35 kg/m2 and significant comorbidities AND
• can show that dietary attempts at weight control have been ineffective

The overall care of patients undergoing bariatric surgery requires programs that address both preperatory care and long-term management. Careful medical evaluations and patient preparation are critical to success. Patients should have a clear understanding of expected benefits, risks, and long-term consequences of surgical treatment. Surgeons must know how to diagnose and manage complications specific to bariatric surgery. Patients require lifelong follow-up with nutritional counseling and fitness regulations.

Physicians should understand the needs of severely obese patients in terms of facilities, supplies, equipment, and staff necessary to meet these needs, and should ensure that the staff and is included in treatment of these patients. This multi-disciplinary approach includes medical management of dietary instruction, exercise training, specialized nursing care, and psychological assistance as needed on an individual basis.

Bariatric procedures rely on two primary mechanisms to promote weight loss: gastric restriction and intestinal malabsorption. Gastric restriction operations include various gastric banding procedures and the vertical banded gastroplasty.

Minimally invasive approaches have been used in bariatric surgery since 1993. The overall outcome following laparoscopic weight loss surgery appears to be comparable to that following equivalent open procedures. Not all patients are suitable for laparoscopic weight reduction surgery, and conversion to an open bariatric procedure is sometimes necessary.

Virtually all bariatric operations can be performed with laparoscopic techniques. Morbid obesity is a significant health concern. Currently, bariatric surgical procedures are the most effective means to achieve significant, sustained weight loss, and thereby provide effective and durable treatment of the obesity-associated morbidities in comparison to fad diets, meal supplements and get-fit-quick exercise programs. Laparoscopic approaches, based on their "open" counterparts, are available.

 When performed by appropriately trained surgeons, laparoscopic approaches appear to speed the patient’s recovery and help patients return to a normal, productive life.