Bariatric surgery: techniques, outcomes and complications

Bariatric or weight loss surgery is the only treatment for morbid obesity that confers definitive weight loss at long-term follow-up. In addition to weight reduction there is a strong possibility of amelioration or even cure of various co-morbid conditions associated with obesity such as Type II diabetes mellitus, obstructive sleep apnoea, hypertension, asthma, osteoarthritis and gastro-oesophageal reflux disease.

Laparoscopic bariatric surgery is now the gold standard technique in weight loss surgery with the Roux-en-Y Gastric Bypass, Adjustable Gastric Band and Sleeve Gastrectomy being the commonly performed surgeries in Europe, United States and Australia.

This review aims to outline the technique, efficacy and complications of these procedures as well as outline the less commonly performed though highly efficacious Bilio-pancreatic Diversion and Duodenal Switch. For the maximal benefit of any of the above weight loss surgeries it is essential the management of these patients be within a multi-disciplinary team (MDT) setting. Indeed it is the vital contributions of the anaesthesiologists, dieticians, clinical psychologists and diabetologists as well as technically sound surgery that ensures a successful outcome from bariatric surgery.