Question:
Want some information on the evolution of bariatric surgery?

The Evolution of Bariatric Surgery Intestinal Bypass also known as the jejunal-ileal bypass, was the most common bypass operation of the 1970's. This procedure has since been abandoned because of malabsorption effects on the liver and other-organs. Most earlier jejunal-ileal bypasses have been reversed by surgical procedures and upgraded to the gastric restrictive operations. Simple Gastric Stapling has been abandoned generally due to the failure of the operation to maintain adequate weight loss, and particularly, due to the high incidence of failure because of the breakdown of staple lines. Horizontal Gastroplasty has failed for many of the same reasons as simple gastric stapling and has likewise been abandoned. Pancreatobiliary Diversion is an operation used in Europe but infrequently In the United States. The NIH Consensus Report indicates there is a high frequency of metabolic complications. Vertical Banded Gastroplasty is one of the two major types of operations recognized by the NIH for the treatment of clinically severe obesity. It is a purely restrictive procedure with no malabsorptive effect. This operation is commonly performed in this country and is a suitable surgical procedure with a very acceptable rate of complications and operative risk. The goal of this procedure is to severely restrict the patient's capacity to eat certain foods. The downside is that it attains a somewhat unpredictable level of weight loss. In addition, it may require difficult modifications. Roux-en-Y Divided Gastric Bypass (RYDGB) is recognized by the NIH Consensus Report for the effective treatment of clinically severe obesity. This is the procedure favored by many surgeons due to the low complication rate and long term, proven results in achieving weight loss. This procedure combines a gastric restrictive operation with slow gastric emptying that provides a lifelong tool for the patient in dealing with clinically severe obesity. It has the highest long term success with low rates of mortality, complications and failures. Roux-en-Y Divided Gastric Bypass is currently the "gold standard" in the surgical treatment of clinically severe obesity. This procedure carries a mortality rate of less than one percent, an operative morbidity (complication) rate of 5 to 10 percent, and an effective loss of 50 to 75 percent of excess weight. In most cases, this is enough weight loss to reduce the life threatening dangers which come with co-morbid conditions. How the Roux-en-Y Divided Gastric Bypass Works When the small functioning upper stomach pouch is full (at first this will occur with only a nibble or two), patients experience a sense of fullness. In this way, and because the appetite will also be reduced, the intake of food is dramatically limited. This is what enables weight loss. What food is eaten is digested and absorbed quite well. On an average, patients will lose as much as 100 pounds, sometimes more, or about two thirds of their excess weight in one year. Some people lose a little more, some a little less. Weight loss will continue during the second year at a less rapid rate. About 15 percent of patients will not lose as much weight as they would like. This occurs because it is possible to "outsmart" or "overeat'' bypass operations. For example, liquids slide right through the pouch and are nearly fully absorbed further down in the intestine. If a person with a bypass ingests high calorie liquids or solids, or eats between meals, weight will not be lost. In fact, he or she may regain the weight already lost.    — kathy S. (posted on July 5, 2000)

July 5, 2000
Can you please tell me the website address? Thanks.
   — rosemary I.

July 6, 2000
This is all great information, don't know what the source is for Kathy, but it seems to be word for word the information provided by Pacific Bariatrics in San Diego.
   — Connie G.