ABSTRACT
The use of bariatric/metabolic surgical approaches in the management of obesity has continued to increase worldwide because this form of treatment produces the most durable weight loss along with many metabolic benefits. In this chapter, the criteria for selecting patients are reviewed, and the benefit of early surgical treatment of metabolic disease is discussed. The approaches to pre-operative and post-operative management are described. The various surgical procedures including Roux-en-Y gastric bypass, sleeve gastrectomy, gastric plication, one anastomosis gastric bypass, biliopancreatic diversion with duodenal switch, and single anastomosis duodeno-ileal bypass with sleeve gastrectomy are described in detail. Operative morbidity and mortality with bariatric/metabolic surgery are discussed, which is comparable to other gastrointestinal operations but includes specific concerns for the patient with obesity. Finally, the impressive outcomes of bariatric and metabolic surgery on multiple diseases are reviewed.
