40 years of advances in Bariatric Surgery
DOI:
https://doi.org/10.19230/jonnpr.1542Keywords:
Obesity surgery, Bariatric surgery, Community hospital, Bariatric tendenciesAbstract
Introduction: Bariatric surgical practice changes in the community setting may be under-reported. We present the developments in a Spanish bariatric surgical practice in the community setting of Alcoy from 1977 through the present.
Methods: Bariatric surgical techniques employed in a country community setting over the course of nearly four decades were reviewed retrospectively and qualitatively.
Results: Surgeons and medical professionals from Alcoy, Spain were involved in the evolution of bariatric surgery patient management and surgical technique from 1977s through 2017. During the last 40 years, 1,495 patients were treated in our clinics. Spanish bariatric surgeons contributed to advances in gastric bypass (GBP) in the 1970s, vertical banded gastroplasty (VBG) in the 1980s, bilio-pancreatic diversion/duodenal switch (BPD/DS) in the 1990s, and innovations associated with laparoscopy from the 1990s onward. Outcomes and approaches to prevention and treatment of bariatric surgical complications are reviewed from a community perspective. Contributions to the bariatric surgical nomenclature and weight-loss reporting are noted.
Conclusions: The practice of bariatric surgery in the community hospital and private clinic must be updated continuously, as in any human and surgical endeavor. Medical professionals in community bariatric practices should contribute their experiences to the field through all avenues of scientific interaction and publication.
Downloads
References
Henrikson V. Is small bowel resection justified as treatment for obesity? Nordisk Medicin 1952; 47: 744
Linner JH. Overview of surgical techniques for the treatment of morbid obesity. Gastroenterol Clin North Am 1987; 16:253-72.
Payne JH, De Wing L, Commons RR: Metabolic Observations in Patients with Jejunocolic Shunts. Am J Surg 1963; 106:273-89
Buchwald H. Lowering of the cholesterol absorption and blood levels by ileal exclusion. Circulation.1964; 29:711–50.
Shikora SS. Biography: Henry Buchwald, M.D., Ph.D. Obes Surg. 2016;26:3–4.
Mason EE, Ito C. Gastric bypass in Obesity. Surg Clin North. 1967;47:1345–52.
Baltasar A, Del Río J, Bengochea M. Bypass gástrico en la obesidad mórbida. Rev Clín Española.1980; 157:395–9.
Baltasar A. Dominguez-Adame. Beginnings of bariatric and metabolic surgery in Spain. Cir Esp.2013;91:413–6.
García Díaz S. Indicaciones del tratamiento quirúrgico en la obesidad. Rev Quir Esp. 1975;2:165–72.
García S, Pera C, Loscertales J, Arévalo E. Estado actual de la cirugía de la obesidad. REEAD. 1977; 51:1–25.
García S, Pera C, Loscertales J, Arévalo JE. Cirugía de la obesidad. Advances Cirugía. 1979; 2:209–24.
García S, García G. Medical and surgical indications for treatment of morbid obesity. World J Surg. 1981; 5:795–9.
Scott H, Dean R, Skull J et al. New considerations in use of yeyuno- ileal by-pass in morbid obesity. Ann. Surg. 1973; 177:723
Mason EE. Vertical banded gastroplasty in obesity. Arch Surg. 1982; 157:701–6.
Baltasar A. Suturas mecánicas en la cirugía de la obesidad. Rev Soc Andaluza Patología Digestiva. 1987; 10:555–6.
Andreo L, Lasierra R, Baltasar A, et al. Evaluación radiológica de la gastroplastia vertical anillada. Radiología. 1988;30:303–8.
Baltasar A. Modified vertical gastroplasty: Technique with vertical division and serosal patch. Acta Chir Scand. 1989;155:107–12.
McLean LD, Rhode BM, Sampalis J, et al. Results of the surgical treatment of obesity. Am J Surg. 1993; 165:155–62.
Baltasar A, Tomás J, Marcote E, et al. Cirugía bariátrica: Experiencia con 100 casos operados. Cir Esp. 1991;50:271–7.
Baltasar A, Bou R, del Río J, et al. Cirugía bariátrica: Resultados a largo plazo de la gastroplastia vertical anillada. ¿Una esperanza frustrada? Cir Esp. 1997;62:175–9.
Baltasar A, Bou R, Arlandis F, Martínez R, et al. Vertical banded gastroplasty at more than five years. Obes Surg. 1998;8:29–34.
Baltasar A, Marcote E, Bou R, et al. Exclusión ileal parcial en la hipercolesterinemia. Cir Esp. 1991;49:475–8.
Favretti F, Cadière G.B, Sega G.: Laparoscopic Banding: Selection and Technique in 830 Patients Obesity Surgery,12, 385-39
Carbajo MA, Martin JC, Blanco JJ.: Banda gástrica ajustable en el tratamiento de loa obesidad mórbida. Cir Esp 1988, 63:185-8
Baltasar A, Bou R, Marcote E, et al. Hybrid bariatric surgery: Biliopancreatic diversion and duodenal switch. Obes Surg. 1995;5:419– 23.
Baltasar A. El cruce duodenal: Una terapia efectiva en la obesidad mórbida. Estudio intermedio. Cir Esp. 2001;69:445–50.
Baltasar A. Preliminary results of the duodenal switch. Obes Surg. 1997;7:500–4.
Baltasar A, Bou R, Bengochea M, et al. Cirugía híbrida bariátrica: Cruce duodenal en la derivación Biliopancreática por obesidad. VRC. 1996;12:16–41. www.youtube.com/watch?v=h0nTzeUDI5o
Hess DS, Hess DW. Biliopancreatic diversion with a duodenal switch. Obes Surg. 1988;8:267–82.
Marceau P, Biron S, Bourque RA et al: Biliopancreatic Diversion with a New Type of Gastrectomy. Obesity Surgery 1993,3:29-35.
Martínez RM, Baltasar A. Estudio del vaciado gástrico en pacientes con obesidad mórbida intervenidos por cruce duodenal. Rev Esp Enf Digest. 1997;89:413–4.
Baltasar A, Bou R, Bengochea M, Arlandis F. et al. Duodenal switch: An effective treatment for morbid obesity. Intermediate study. Obes Surg. 2001;11:54–9.
Baltasar A. El cruce duodenal: Una terapia efectiva en la obesidad mórbida. Estudio intermedio. Cir Esp. 2001;69:445–50.
Pérez N, Baltasar A, Serra C, et al. Comparative analysis of vertical banded gastroplasty and duodenal switch at five years follow-up. Obes Surg. 2005;15(7):1061–5.
Pérez N, Serra C, Baltasar A, et al. Resultado comparativo entre la GVA y el CD en la obesidad mórbida. Cir Esp. 2006;79:283–8.
Deitel M. Surgery for the morbidly obese patient. London: Lea & Febiger, 1989.
Deitel M, Shikora S. Mervyn Deitel—Biography. Obes Surg. 2016;26:707–8.
Deitel M, Gagner M, Dixon JB, Himpens J, Madan A (eds).Handbook of Obesity Surgery. Toronto: FD-Communications Inc., 2010.
Deitel M, Cowan G. Update: Surgery for the Morbidly Obese Patient 2000. Toronto: FD-Communications, Inc., 2000.
Wittgrove A, Clark W, Tremblay L. Laparoscopic gastric bypass. Roux- en-Y. Preliminary report. Obes Surg. 2004;4:353–7.
Wittgrove A, Clark W. Laparoscopic gastric bypass. Roux-en Y. Experience with 27 cases with 3-18 months follow up. Obes Surg. 2006;6:54–7.
Wittgrove A, Clark W, Schubert K. Laparoscopic gastric bypass. Roux- en Y. Technique and results in 75 patients with 3-30 months follow up. Obes Surg. 2006;6:500–4.
Martínez R, Arlandis F, Baltasar B, et al. Vascular (aorta) reconstruction for retroperitoneal sarcomas I, VRC. 1999;16.4:15–7.
Baltasar A. Iterative oncologic-vascular surgery for recurrent retroperitoneal sarcoma. Vascular trans-pubis cross-over (arterial and venous) re-construction for retroperitoneal sarcomas II. VRC. 1999;16.4:31–4.
Baltasar A, Bou R, Miró J, Serra C, et al. Bypass gástrico por laparoscopia. Cir Esp. 2000;67:556–9.
Gusfavvson S, Westling A. Laparoscopic Roux-en-Y gastric bypass. Uppsala, Sweden. Obes Surg. 1998;8:392.
Baltasar A, Bou R, Bengochea M, Miró J, Arlandis F. Lap Roux-Y gastric bypass. Alcoy. Spain. Obes Surg. 1998;8:393.
Serra C, Baltasar A. Internal hernias and gastric perforation after laparoscopic gastric bypass. Obes Surg. 1999;9:546–9.
Higa K, Ho T, Boone K. Internal hernias after laparoscopic Roux-en-Y gastric bypass: Incidence, treatment and prevention. Obes Surg. 2003;13:350–4.
Baltasar A, Bou R, Miró J, et al. Laparoscopic gastric bypass. Bypass gástrico laparoscópico. Rev Esp Enferm Ap Dig. 2000;10:661–4.
Wittgrove A. Chapter 21: Laparoscopic gastric bypass. Circular stapler technique. In: Obesity Surgery: Principles and Practice (eds. Pitombo C, Jones KB, Higa KD, Pareja JC, eds). Albany, New York: McGraw Hill Medical;2007, 221-224.
Dabi Y, Darrigues L, Katsahian S et al.: Publication Trends in Bariatric Surgery: a Bibliometric Study. Obes Surg 2016;26:2691–2699. DOI 10.1007/s11695-016-2160-x
Carbajo M, García-Caballero M, Toledano M et al : One-Anastomosis Gastric Bypass by Laparoscopy: Results of the First 209 Patients. Obesity Surgery 2005, 15, 398-404
Pernaute A, Perez E, Torres et al: Modern Surgery: Technical Innovation “Right-Angled” Stapled Latero-lateral Duodenojejunal Anastomosis in the Duodenal Switch. Obesity Surgery2005, 15, 700-702
Ren CJ, Patterson E, Gagner M. Early results of laparoscopic biliopancreatic diversion with duodenal switch: a case series of 40 consecutive patients. Obes Surg. 2000;10:514–23.
Baltasar A. Bou R, Miro J, et al. Laparoscopic duodenal switch. Technique and initial experience. Obes Surg. 2001;12:245–8.
Baltasar A. Hand-sewn laparoscopic duodenal switch. Surg Obes Relat Dis. 2007;3:94–6.
Baltasar A. Chapter 29: Laparoscopic biliopancreatic diversion. The duodenal switch.In: Obesity Surgery: Principles and Practice (eds. Pitombo C, Jones KB, Higa KD, Pareja JC, eds). Albany, New York: McGraw Hill Medical; 2007, pp.241–3.
Baltasar A. El Cruce Duodenal. Guía Clínica de obesidad de Cirugía Española, Chapter 29.Madrid, Spain: S.A. Arán Ediciones, 2007.
Weiner RA, Blanco-Engert R, Weiner S, et al. Laparoscopic biliopancreatic diversion with duodenal switch: Three different duodeno- ileal anastomotic techniques and initial experience. Obes Surg. 2004;14,334–40.
Baltasar A. Obesidad y Cirugía. Cómo dejar de ser obeso. Madrid, Spain: S. A. Aran Ediciones, 2000.
Martínez R, Baltasar A, Vidal V, et al. Estudio de vaciado gástrico en pacientes con obesidad mórbida intervenidos por cruce duodenal. REED. 1997:89:413–4.
Bueno J, Pérez N, Serra C, Bou R, Miró J, Baltasar A. Fístula pancreato-cutánea secundaria a pancreatitis postoperatoria tras cruce duodenal laparoscópico. Cir Esp. 2004;76(3):184–6.
Serra C, Baltasar A, Losa JL, et al. Taponamiento cardiaco provocado por perforación de catéter venosa central. Cir Esp. 1999;65:470–1.
Baltasar A, Serra C, Pérez N, et al. Clinical Hepatic Impairment after the Duodenal Switch. Obes Surg. 2014;14:77–8.
Baltasar A. Liver cirrhosis and bariatric operations. Surg Obes Relat Dis. 2006;2:580–1.
Baltasar A. Liver failure and transplantation after duodenal switch. Surg Obes Relat Dis. 2014;10:e93–6.
Serra C, Baltasar A, Pérez N, et al. Total gastrectomy for complications of the duodenal switch. Obes Surg. 2006;16:1082–6.
Baltasar A, Bou R, Bengochea M, Serra C. Protein caloric malnutrition. Three types of bowel lengthening. BMI–Latina. 2011;1.2.5:96–7.
Baltasar A, Bou R, Bengochea M. Fatal perforations in laparoscopic bowel lengthening operations for malnutrition. Surg Obes Relat Dis. 2010;20:140–7.
Baltasar A. Letter to the editor: Roux-en-Y to duodenal switch. Surg Obes Relat Dis. 2008;4:208–11.
Baltasar A, Serra C, Pérez N, et al. Laparoscopic sleeve gastrectomy. A multi-purpose operation. Obes Surg. 2005;15:1124–8.
Ahmad SS, Ahmad SS, Kohl S. The Hundred Most Cited Articles in Bariatric Surgery. Obes Surg. 2015;25:900–9.
Serra C, Pérez N, Bou R, Bengochea M, Martínez R, Baltasar B. Gastrectomía tubular laparoscópica. Una operación bariátrica con diferentes indicaciones. Cir Esp. 2006;79:289–92.
Sánchez-Santos R, Masdevall C, Baltasar A, et al. Short- and mid- term outcomes of sleeve gastrectomy for morbid obesity: The experience of the Spanish National Registry. Obes Surg. 2009;19:2019–23.
Baltasar A, Serra C, Pérez N. Re-sleeve gastrectomy. Obes Surg. 2006;16:1535–8.
Serra C, Baltasar A. Re-gastrectomía tubular. Cir Esp. 2007;82.1:240.
Baltasar A, Bou R, Bengochea M, Serra C, Pérez N. Intubación difícil y traqueotomía en el obeso mórbido. Difficult intubation and tracheotomy in the morbidly obese. BMI-Latina. 2013;3:4–7.
Baltasar A, Bou R, Bengochea M, Serra C, Pérez N. Laparoscopic gastric sleeve, subtotal antrectomy and omentoplasty. Obes Surg. 2015;25:195–6.
Baltasar A, Pérez N, Bou R, Miro J, Bengochea M, Arlandis F, Escrivá C, Serra C, Martínez R. Wall-stent prosthesis for severe leak and obstruction of the duodenal switch Gastric tube. Obes Surg. 2000;10:309.
Serra C, Baltasar A, Andreo L, et al. Treatment of gastric leaks with coated self-expanding stents after sleeve gastrectomy. Obes Surg. 2007;17:866–2.
Baltasar A, Bou R, Bengochea M, et al. Use of a Roux limb to correct esophagogastric junction fistulas after sleeve gastrectomy. Obes Surg. 2007;17:1409–10.
Baltasar A, Serra C, Bengochea M, Bou R. The use of a Roux-en-Y loop for sleeve gastrectomy fistulas. Bariátrica & Metabólica. 2008;3:20– 3.
Baltasar A, Serra C, Bengochea R, et al. Use of Roux limb as remedial surgery for sleeve gastrectomy fistulas. Surg Obes Relat Dis. 2009;4:759–63.
Gagner M, Deitel M, Traci L, et al. The second international consensus summit for sleeve gastrectomy, March 19–21, 2009.Surg Obes Relat Dis. 2009;5:476–85.
Deitel M, Gagner M, Erickson A. et al. Third international summit: current status of sleeve gastrectomy. Surg Obes Relat Dis. 2011;7:749– 59.
Baltasar A. Historical note: First diabetes metabolic operation in Spain. Int Obes Dia. 2015;25:180–2.
Baltasar A. Primera operación de diabetes en España. BMI-Latina. 2016;6:996–9.
Marceau R, Biron S, Marceau S et al. Biliopancreatic diversion- duodenal switch: Independent contributions of sleeve resection and duodenal exclusion. Obes Surg. 2014;24:1843–9.
Bou R, Baltasar A, Pérez N, et al. Cirugía de la diabetes: Gastrectomía vertical y desvío duodenal. BMI-Latina. 2012;2:400–3.
Baltasar A, Bou R, Bengochea M, Serra C, Pérez N. Mil operaciones bariátricas. One thousand bariatric operations. Cir Esp. 2006;79:349–55.
Baltasar A, Serra C, Bou R, et al. Sleeve gastrectomy in a 10-year-old child. Obes Surg. 2008;18:33–6.
Baltasar A. Nine years follow up of the 1st Adolescent Bariatric Surgery in Spain. J J Obesity. 2017. 3(1): 026
Scopinaro N, Melissas J, Fried M, Baltasar A. European Chapter of Centers of Excellence Program. Web: http://www.eacbs.com/site/index.php/ifso-endorsed-coe-programs/ifso- ec-coe-program
Baltasar A. Editorial. BMI-Latina. 2011;1:5–9.
Baltasar A, Serra C, Bou R, et al. Complicaciones de la cirugía bariátrica. of Bariatric Surgery complications. BMI-Latina. 2011;1:238– 42.
Baltasar A, Bou R, Bengochea M. Cruce duodenal abierto. Open duodenal switch. Video. BMI-Latina. 2011;1:357–60.
Baltasar A, Bou R, Bengochea M, et al. Cruce duodenal manual laparoscópico. Laparoscopic hand-sewn duodenal switch. Video. BMI- Latina. 2012;2:387–9.
Serra C, Pérez N, Bou R, Baltasar A. Sliding self-locking first stitch and Aberdeen Knot in suture reinforcement with omentoplasty of the laparoscopic gastric sleeve staple line. Obes Surg. 2014;24:1739–40. Video: https://youtu.be/MXf0aiWp_kE
Baltasar A, Bou R, Serra C, Bengochea M, Pérez N. Use of self- locking knots in running intestinal bariatric sutures. Global Surg 2015;2:100-1.
Baltasar A, Bou R, Serra C, et al. Video. Stapling of the bougie in the sleeve gastrectomy. Surg Obes Relat Dis. 2016:12:1136-1138. DOI http:11Dx.org/10.16/j.sorad.2016.01.02.
Baltasar A. Simple telemedicina bariátrica. Simple bariatric telemedicine. BMI-Latina. 2016,5:900–1.
Baltasar A.: WhatsApp© Assistance in Bariatric Surgery. Journal of obesity and eating disorders 2017.3:28-9.DOI: 10.21767/2471- 8513.100017of
Shikora S, Torres A. Biography: Aniceto Baltasar. Obes Surg 2016;26:477–8.
Baltasar A. Nomenclatura utilizada en cirugía bariátrica. Cir Esp. 2008;83:220–1.
Baltasar A. Gastroplastia o gastrectomía, gastroplasty versus gastrectomy. Cir Esp.2009;85:325–6.
Baltasar A. Editorial: Nomenclatura utilizada en cirugía bariátrica. Nomenclature of bariatric terms. BMI-Latina. 2011;1:278.
Baltasar A. La Real Academia Nacional de Medicina de España dice. La gastrectomía vertical es el término correcto. BMILatina. 2012;2:381– 3.
Baltasar A. Laparoscopic sleeve gastrectomy is a misnomer. Surg Obes Relat Dis.2012;8:127–31.
Baltasar A. Sleeve-forming gastrectomy is the right terminology. Obes Surg.2015:25:935–7.
Baltasar A, Deitel M, Greenstein R. Weight loss reporting. Obes Surg. 2008;18:761–2.
Baltasar A et al. IMC esperable tras cirugía bariátrica. Expected BMI after bariatric operations. Cir Esp.2009;86:308–12.
Baltasar A, Pérez N, Serra C, Bou R, Bengochea M, Borrás F. Weight loss reporting: Predicted BMI after bariatric surgery. Obes Surg. 2011;212:367–72.
Molina A, Fatima F, Vives M. et al.: Usefulness of Baltasar’s expected body mass index as an indicator of bariatric weight loss surgery. Obes Surg. 2016. DOI 10.1007/s11695-016-2163-7
Downloads
Published
Issue
Section
License
All accepted originals remain the property of JONNPR. In the event of publication, the authors exclusively transfer their rights of reproduction, distribution, translation and public communication (by any sound, audiovisual or electronic medium or format) of their work. To do so, the authors shall sign a letter transferring these rights when sending the paper via the online manuscript management system.
The articles published in the journal are freely used under the terms of the Creative Commons BY NC SA license, therefore.
You are free to:
Share — copy and redistribute the material in any medium or format
Adapt — remix, transform, and build upon the material
The licensor cannot revoke these freedoms as long as you follow the license terms.
Under the following terms:
Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.
NonCommercial — You may not use the material for commercial purposes.
ShareAlike — If you remix, transform, or build upon the material, you must distribute your contributions under the same license as the original.
No additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License
