الفهرس | Only 14 pages are availabe for public view |
Abstract At the turn of the twenty-first century, over weight (body mass index (BMI) ≥ 25 kg/m²) is a world wide epidemic involving two pillion people, including nearly two thirds of US citizens, of whom 50-60 million are obese (BMI ≥ 30 Kg/m²) and about 10 million are morbidly obese (BMI ≥ 40 Kg/m²or ≥ 35 Kg/m² with significant co-morbidities). The co-morbid conditions of morbid obesity are responsible for decrease in life expectancy for about 9 years in women and about 12 years in men. Unfortunately, long term weight loss results with diet therapy, with or without support organization, has failed in the treatment of this disease. There are currently no truly effective pharmaceutical agents to treat obesity. Bariatric surgery today is the treatment of choice and the only effective therapy in management of morbid obesity. Morbid obesity is associated with large numbers of problems. The fundamental differences between minimally invasive bariatric surgery and open bariatric surgery are the methods of abdominal wall access and operative exposure, by reducing size of surgical incision and trauma associated with the operative exposure. Advantages of minimally invasive bariatric surgery include less impairment of post operative pulmonary function and pulmonary atelectasis, other advantages include lower operative blood loss, shorter hospital stay, reduction of post operative pain and faster recovery. The main disadvantage of laparoscopic approach is the steep learning curve to overcome. The laparoscopic approach doesn’t change the risks of bypass of upper digestive system. Biliopancriatic diversion is considered the most effective procedure for surgical treatment of obesity like any other painful weapon; it can be dangerous if used improperly. Laparoscopic surgery has become an appropriate restrictive procedure with good short term results and law morbidity rates. |