CLINICALLY SEVERE OBESITY AND/OR MORBID OBESITY ARE RECOGNIZED AS MAJOR PUBLIC HEALTH RISKS THROUGHOUT THE WORLD. SEVERE OBESITY, SOMETIMES KNOWN AS “MORBID OBESITY”, IS DEFINED AS BEING APPROXIMATELY 100 POUNDS (45.5 KG) OR 100% ABOVE IDEAL BODY WEIGHT.IN THE U.S.A. ALONE, OVER SIX MILLION PEOPLE SUFFER FROM THIS CHRONIC DISEASE. IN IRAN, IT SEEMS THAT MORBID OBESE POPULATION GROWS. THE CAUSE OF SEVERE OBESITY IS POORLY UNDERSTOOD. THERE ARE PROBABLY MANY FACTORS INVOLVED. IN OBESE PERSONS, THE SET POINT OF STORED ENERGY IS TOO HIGH. THIS ALTERED SET POINT MAY RESULT FROM A LOW METABOLISM WITH LOW ENERGY EXPENDITURE, EXCESSIVE CALORIC INTAKE, OR A COMBINATION OF THE ABOVE. THERE IS SCIENTIFIC DATA THAT SUGGESTS OBESITY MAY BE AN INHERITED CHARACTERISTIC. SEVERE OBESITY IS MOST LIKELY A RESULT OF A COMBINATION OF GENETIC, PSYCHOSOCIAL, ENVIRONMENTAL, SOCIAL AND CULTURAL INFLUENCES THAT INTERACT RESULTING IN THE COMPLEX DISORDER OF BOTH APPETITE REGULATION AND ENERGY METABOLISM. SEVERE OBESITY DOES NOT APPEAR TO BE A SIMPLE LACK OF SELF-CONTROL BY THE PATIENT. MUCH OF THE ASSOCIATED MORBIDITY AND MORTALITY IS RELATED TO CO-MORBID CONDITIONS WHICH INCLUDE, BUT ARE NOT LIMITED TO, CARDIAC DISEASE, TYPE II DIABETES MELLITUS, OBSTRUCTIVE SLEEP APNEA, [PICKWICKIAN SYNDROME], HYPERTENSION, DYSLIPIDEMIA, GASTROESOPHAGEAL REFLUX DISEASE, STRESS URINARY INCONTINENCE, ARTHRITIS OF THE WEIGHT BEARING JOINTS, INFERTILITY AND SOME CANCERS.NUMEROUS THERAPEUTIC APPROACHES TO THIS PROBLEM HAVE BEEN ADVOCATED, INCLUDING LOW CALORIE DIETS, MEDICATION, BEHAVIORAL MODIFICATION AND EXERCISE THERAPY. HOWEVER, THE ONLY TREATMENT PROVEN TO BE EFFECTIVE IN LONG-TERM MANAGEMENT OF MORBID OBESITY IS SURGICAL INTERVENTION. LAPAROSCOPIC SURGERY FOR OBESITY IS FOR PEOPLE WHO ARE SEVERELY OVERWEIGHT. LAPAROSCOPY INVOLVES USING A SPECIALIZED TELESCOPE (LAPAROSCOPE) TO VIEW THE STOMACH, WHICH TYPICALLY ALLOWS SMALLER ABDOMINAL INCISIONS. A NUMBER OF WEIGHT LOSS OPERATIONS HAVE BEEN DEVISED OVER THE LAST 40-50 YEARS. THE OPERATIONS RECOGNIZED BY MOST SURGEONS INCLUDE: VERTICAL BANDED GASTROPLASTY, GASTRIC BANDING (ADJUSTABLE OR NON-ADJUSTABLE), ROUX-EN-Y GASTRIC BYPASS, AND MALABSORBTION PROCEDURES (BILIOPANCREATIC DIVERSION, DUODENAL SWITCH). THE VERTICAL BANDED GASTROPLASTY INVOLVES THE CONSTRUCTION OF A SMALL POUCH THAT RESTRICTS THE OUTLET TO THE LOWER STOMACH. THE OUTLET IS REINFORCED WITH A PIECE OF MESH (SCREEN) TO PREVENT DISRUPTION AND DILATION. THE LAPAROSCOPIC GASTRIC BAND INVOLVES PLACING A 1/2 INCH BELT OR COLLAR AROUND THE TOP PORTION OF THE STOMACH. THIS CREATES A SMALL POUCH AND A FIXED OUTLET INTO THE LOWER STOMACH. THE ADJUSTABLE BAND, WHICH WAS APPROVED BY THE FDA IN JUNE 2001, CAN BE FILLED WITH STERILE SALINE. WHEN SALINE IS ADDED, THE OUTLET INTO THE STOMACH IS MADE SMALLER WHICH FURTHER RESTRICTS FOOD FROM LEAVING THE POUCH. THE GASTRIC BYPASS PROCEDURE INVOLVES DIVIDING THE STOMACH AND FORMING A SMALL GASTRIC POUCH. THE NEW GASTRIC POUCH IS CONNECTED TO VARYING LENGTHS OF YOUR OWN SMALL INTESTINE CONSTRUCTED INTO A Y-SHAPED LIMB (ROUX-EN-Y GASTRIC BYPASS). THE MALABSORBTION OPERATIONS CAUSE WEIGHT LOSS BY DECREASING ABSORPTION OF CALORIES FROM THE INTESTINES. THESE OPERATIONS INVOLVE REDUCING THE STOMACH SIZE AND BYPASSING MOST OF THE INTESTINES. CHOOSING BETWEEN THE DIFFERENT OPERATIVE PROCEDURES INVOLVES THE SURGEON’S PREFERENCE AND CONSIDERATION OF THE PATIENT’S EATING HABITS.
FOR MORE INFORMATION, SEE SAGES PREPAIRED POWERPOINT IN LAPAROSCOPIC WEIGHT LOSS SURGERY (BARIATRIC SURGERY) .DOWNLOAD FILM.