Jejunoileal Bypass Procedures
The first metabolic surgery dates to 1954, performed at the University of Minnesota. Called the jejunoileal bypass and based on the theory of malabsorption, this procedure bypass much of the small intestine and was devised to treat severe dyslipidemia, abnormally elevated levels of cholesterol or fats in the blood. If a portion of the digestive tract could be bypassed, then the body would absorb fewer nutrients and calories, thus resulting in weight loss. Although weight loss following this procedure was significant, it also resulted in undesirable side effects, such as severe dehydration and diarrhea.
Surgeons attempted several modifications of this procedure during the 1960s and 1970s, but its inherent flaws prevented it from gaining widespread acceptance. The procedure bypassed most of the small intestine while keeping the stomach intact.
The Start of Bariatric Surgery
Dr. Edward E. Mason introduced the first technique labeled bariatric surgery in the 1960s. Dr. Mason observed that patients who had a portion of their stomach removed to treat stomach cancer or ulcers experienced the unexpected side effect of significant weight loss. He determined that the same technique could be used to encourage weight loss in obese patients.
The initial method used involved a horizontal gastric pouch with a loop bypass. This procedure eventually developed into the roux-en-y gastric bypass utilizing a smaller stomach pouch that are more restrictive while eliminating the bile reflux that occurred in many patients with the original procedure. Roux-en-y gastric bypass removes a greater portion of the stomach and bypasses just enough of the intestines to limit calorie intake without resulting in dehydration or severe malabsorption. Compared to the jejunoileal bypass, this weight loss operation for morbid obesity resulted in less diarrhea, kidney stones and gallstone while also improving liver fat content.
Additional Treatment Advances
Many of the bariatric procedures currently used today by surgeons are variations on gastric bypass. However, the laparoscopic technique is the one major advance that has further enhanced the safety of bariatric and metabolic surgery.
Laparoscopic Gastric Bypass Surgery
Alan Wittgrove performed the first laparoscopic bypass surgery in 1994. The laparoscopic technique is responsible for the exponential growth of weight loss surgery as it only requires small incisions, which reduce the risk of complications and allows for a shorter recovery time.
Other Bariatric Surgery Techniques
Scientists also developed purely restrictive measures, such as the sleeve gastrectomy and the adjustable gastric band, as alternatives to laparoscopic gastric bypass. These techniques have less surgical morbidity and are simpler to perform, making them more attractive to some patients. At the same time, patients need to be highly motivated to eat less food and not stretch their stomach pouch.
For treatment of morbid obesity, the modified duodenal switch (DS) with single anastomosis (SADI/SIPS), was first performed in 2013 by Daniel Cottam and Mitchell S. Roslin. This bariatric procedure involves creating a gastric sleeve that removes about 80% of the stomach along with a diversion with duodenal switch that requires less rerouting of the small intestine that results in a shorter surgery time and less chance of complications.
Learn More About Bariatric Surgery
At Tijuana Bariatric Center, we offer a comprehensive range of bariatric surgical procedures that allow patients to safely lose the weight that compromises their health. If you would like to learn more about these services to improve your quality of life, contact us at your earliest convenience by calling 1-800-970-0577 to schedule your free virtual consultation.
