Bariatric surgery - History

Bariatric or “weight loss” surgery began in the 1950s. Early surgeries were done because doctors noticed that patients who had abdominal surgery that shortened the length of their intestine, or reduced the size of their stomachs tended to lose weight.

Doctors used this knowledge to develop two schools of thought regarding surgery for weight loss.

• Decrease the ability of the small intestine to absorb calories and nutrients (Malabsorptive).
• Reduce the size of the stomach to restrict the amount of food a patient can eat at one time (Restrictive).

The first weight loss surgeries were associated with significant postoperative complications including severe electrolyte and protein imbalance resulting in malnutrition. Some were associated with lifelong risk of liver failure from cirrhosis.

Certain other types of operations designed to restrict the size of the stomach failed due to breakdown of the staple lines to partition the stomach into a smaller reservoir.

It is important that anybody considering bariatric surgery be very familiar with how the gastroinestinal tract works.

Your success with weight loss relies on your ability to make the changes from surgery `work to your advantage.

The function of the GI tract is to allow the food you eat to be used by your body to give you nutrients and calories needed to be active and stay healthy.

Any food you eat that is not needed for immediate energy is either eliminated or stored in your body as fat.

Once you chew and swallow your food it passes down the esophagus. The purpose of the esophagus is to warm any cold liquids or foods and serves as a passage between the mouth and the stomach

In the stomach food is diluted by gastric secretions, which also include a high level of acid. Your stomach acts as a mixing area for this acid bath as well as a reservoir for food until it can continue into the small intestine.

As food leaves the stomach, it enters the duodenum (the beginning of the small intesting). The duodenum leads to the rest of the small intesting, the jejunum and ileum.

Each part of the intestine has a specialized function and absorbs specific nutrients. In the duodenum, bile and pancreatic juices are added to food.

These aid in the digestion of fats and proteins. The overall length of the small intestine is approximately 20 feet. At the end of the small intestine the food then passes into the large intestine through the ileocecal valve.

The job of the large intestine is to absorb water and electrolytes from the partially digested food. By doing so, it concentrates the remaining food and acts as a reservoir for the fecal material so they can be eliminated every 1-3 days.