During
the 1970s, the most common form of bariatric surgery was intestinal
Bypass. It was very unpopular due to uncontrolled malabsorption issues.
There were also long term, severe problems or side effects that were
not only undesirable, but also unhealthy as the persistent anemia and
the bone calcium depletion.
In the early 80's, Bypass stapling had been modified to some degree
improving late complications but continuing having a high mortality
rate and many operative and postoperative complications specially among
surgeons that were not very familiar with the techniques and follow
up.
Stapling of the Stomach or Vertical Gastroplasty and the Adjustable
Gastric Band became much less aggressive because they were only restrictive
and not malabsortive procedures and a lower death rate occurred because
there were less failing places and less aggressive because no anastomosis
or several stapling were need it in order to achieve the weightloss.
In 1978, a Gastric Band was introduced as a form of treatment for obesity.
This and the revised way of stapling were the most popular forms of
surgery to help
overcome morbid obesity.
In 1983, Dr. Kuzmak developed an adjustable gastric band for conventional
open surgery, to constrain the proximal gastric lumen and create a restricted
upper compartment or upper pouch, while leaving a large patent distal
segment of stomach in continuity. In laymen terms... It looked like
an obshaped hourglass, still allowing the stomach to digest food, the
way our system is intended to work. One of the greatest differences
between the band used in the 70's and the band in the 80's is, the latter
band was adjustable.
In 1985, there was even a better adjustable band introduced by a Swedish
doctor, Peter Forsell. This band was later used laparoscopically with
great success.
At the end of 1992, Dr. Kuzmak placed the first generation "lapband"
as a laparoscopic surgery.
The LASGB ( Laparoscopic Adjustable Silicone Gastric Banding) does not
involve any cutting, stapling, or removing any part of the stomach and/or
intestines. Most of the side effects associated with all other forms
of bariatric procedures are eliminated with this newer procedure. The
patient is discharged from the
hospital the next day in most cases, regardless of his/her weight. Not
to
mention back to work after a few days rest. Total reversibility and
adjustability of the band, are clearly positive points to be considered.
The creation of a 15 ml gastric upper pouch (1/2 onz) with a narrow
outlet into the remaining stomach produces a feeling of early satiety
with small
amounts of food. Consequently, there is a controlled weight reduction
and
ability to maintain ones weightloss.
The LASGB (lapband) is the first reversible, minimally disabling,
laprascopically feasible gastric compartmentation, in the 40 year history
of
operative surgical treatment for morbid obesity and today is considered
among true Bariatric Surgeons as the first choice for treatment of severe
obesity.