Laparoscopic bariatric surgery-current trends and controversies

Although the origins of bariatric surgery to treat obesity can be traced back to the 1950s with the jejunoileal bypass, which is considered a malabsorptive bariatric procedure, its practice remained in obscurity until two things happened. First, obesity becoming a pandemic disease state with life threatening comorbidities such as diabetes, hypertension, sleep apnea, dyslipidemia and metabolic syndrome, resulting in a higher risk for premature death. Second, the introduction, development, and refinement of minimal access surgical techniques along with newer laparoscopic stapling devices. With the advent of laparoscopy in the 1980s, bariatric surgery began to be performed through minimally invasive techniques. The purpose of this article is to describe the science and evolutionary development of various laparoscopic bariatric surgical techniques and the associated surgical anatomy.