Chirurgie laparoscopique de l’obésité morbide

Abstract

Morbid obesity has become a frequent disease. It refers to an overweight complicated by other diseases. Morbid or pathologic obesity is defined by the body mass index which is based on morbidity and mortality profiles as determined by insurance companies for Caucasian populations. Such high-risk patients may be treated by surgery after failure of conventional medical management and nutritional follow-up. Several surgical procedures – aimed at reducing the disease severity by decreasing patients’ body weight, improving their quality of life, and perhaps their life expectancy – are utilized in open surgery, i.e., laparotomy. Interventions are based on two basic principles of gastric restriction and/ or intestinal malabsorption; these are mainly gastroplasties and gastric bypasses. For a long time, except in some cases, such surgical treatments have been deplored and badly understood in France. Laparoscopic surgery has allowed less invasive interventions and hence, has promoted the development of these procedures. It should not modify their indications. Nevertheless, ideal or universal bariatric intervention still lack, and each of laparoscopic procedures has its own learning curve.