Published online Oct 7, 2014. doi: 10.3748/wjg.v20.i37.13424
Revised: June 15, 2014
Accepted: July 16, 2014
Published online: October 7, 2014
The field of bariatric surgery has been rapidly growing and evolving over the past several decades. During the period that obesity has become a worldwide epidemic, new interventions have been developed to combat this complex disorder. The development of new laparoscopic and minimally invasive treatments for medically-complicated obesity has made it essential that gastrointestinal physicians obtain a thorough understanding of past developments and possible future directions in bariatrics. New laparoscopic advancements provide patients and practitioners with a variety of options that have an improved safety profile and better efficacy without open, invasive surgery. The mechanisms of weight loss after bariatric surgery are complex and may in part be related to altered release of regulatory peptide hormones from the gut. Endoscopic techniques designed to mimic the effects of bariatric surgery and endolumenal interventions performed entirely through the gastrointestinal tract offer potential advantages. Several of these new techniques have demonstrated promising, preliminary results. We outline herein historical and current trends in the development of bariatric surgery and its transition to safer and more minimally invasive procedures designed to induce weight loss.
Core tip: Obesity and its associated co-morbidities are on the rise worldwide and have reached epidemic proportions. Surgical procedures have been developed and refined to manage obesity. Bariatric surgery is now the preferred modality of therapy for medically-complicated obesity. Attempts to replace invasive bariatric techniques are the driving factors behind studies of newer, minimally invasive procedures. Our therapeutic armamentarium continues to expand for treatment of morbid obesity and its medical complication as new research is completed and novel minimally invasive techniques are assessed. Preliminary results in several of these areas are promising and provide practitioners with a potential future array of options and modes of therapy.