[Obesity and surgery].

Abstract

Obesity is a life-long, progressive, life-threatening, genetically related, costly, multifactorial disease manifested by excessive fat storage. It is often accompanied by multiple comorbidities including mainly hypertension, diabetes, hyperlipidemia, hypoventilation, obstructive sleep apnea, degenerative arthritis and psychosocial impairment which influence the patients quality of life and ultimately limit their life expectancy. Conservative treatment of morbid and extreme obesity including diet, physical activity, behaviour modifications or pharmacotherapy is not effective in achieving a medically significant long-term weight loss. The costs of such therapy often exceed the costs of the surgical procedure. Surgical treatment of obesity was initiated over 50 years ago. Then the surgical methods were to lead to an increased excretion but finally did not prove useful. They were replaced by restrictive and malabsorption procedures. The first methods including vertical banded gastroplasty (VBG) were introduced in 1982 while gastric banding in 1985. The second method including gastric bypasses or biliopancreatic diversion were implemented in the years 1966-1986. There are also some methods joining these two techniques. Nowadays as a results of minimally invasive surgery development, most of the operations can be performed laparoscopically.