Surgical Treatment of Obesity and the Metabolic Syndrome

Obesity and obesity-related comorbid conditions have been steadily increasing in the United States over the past few decades. Despite the availability of several anti-obesity measures such as diet, exercise, pharmacotherapy and behavioral modifications, bariatric surgery is the only effective modality that can provide a sustainable long-term weight loss and improve obesity-associated comorbidities. In this chapter, we discuss perioperative assessment and work-up of morbidly obese patients, minimally invasive approaches to various bariatric surgery procedures including laparoscopic adjustable gastric band, sleeve gastrectomy, gastric bypass and biliopancreatic diversion with duodenal switch, and their short and long term outcomes. We also address revisional bariatric surgery and use of robotic platform and other new procedures and their role in metabolic and bariatric surgery. This review contains 7 figures, 2 videos, 2 tables, and 110 references. Keywords: Obesity, comorbidities, metabolic surgery, bariatric surgery, gastric bypass, adjustable gastric band, sleeve gastrectomy, Biliopancreatic Diversion with Duodenal Switch, revisional surgery