History of Bariatric Surgery & The future of weight loss procedures


Bariatric Surgery is aimed at reducing the body weight of a person. The surgery involves making changes to the body’s digestive system so that the body can hold only a small amount of food at a time. This results in the person feeling full with only a few bites. Some bariatric surgeries also adjust the stomach and intestine in such a way that it absorbs fewer calories from food, further aiding in weight loss.

The word Bariatric is derived from the Greek word “Baros” which translates to “weight”. Bariatric means “something related to weight” and in medical terms, Bariatric is associated with procedures pertaining to people who are significantly overweight.

Bariatric surgery is often recommended as a last resort for people who cannot manage their weight with food and exercise, and have become severely obese.

The History of bariatric surgery

Bariatric Surgery has gained widespread popularity in the last two decades. However, it has a long history and with time, doctors were able to develop different types of bariatric surgeries.

The reports of the very first bariatric surgery date back to the 10th century. According to historical reports, the first bariatric surgery was performed on D.Sancho, the King of Leon. The king was so obese that he could not even walk, ride a horse, or wield a sword properly. His condition led to him losing the throne.

He was then treated by the famous Jewish doctor Hasdai Ibn Shaprut who sutured the king’s lips, only leaving a small gap for him to use a straw to feed himself. The king was then made to follow a liquid diet called Teriaca, which was known to have properties that accelerated weight loss. With the doctor’s help, the king was able to reduce his weight in half. The king then successfully took back his throne. Nowadays we use metabolic surgeries thanks to the advancements in medical and surgical science.

The first metabolic bariatric surgery – Jejuno-ileal Bypass (JIB) | Year 1963

Dr. A J Kremen performed the first metabolic surgery in 1954. The procedure was called the Jejuno-ileal (JIB) bypass where the top part of the patient’s small intestine is connected to its lower end. This meant that the food bypasses most of the small intestine, where most of the calorie absorption takes place. Post-surgery, the body can absorb only a few calories from the food.

However, Jejuno-ileal Bypass did have its side effects. People who underwent Jejuno-ileal Bypass (JIB) suffered from a long list of problems including diarrhea, Vitamin deficiency-related problems, and kidney stones, and protein-calorie malnutrition.

Jejuno-ileal Bypass was also called Intestinal Bypass.

The side effects of JIB made it unsuitable for mainstream adoption.

Modifications to JIB – Jejunocolic Shunt | Year 1963

Following the shortcoming of Jejuno-ileal Bypass (JIB), three doctors Drs. Payne, DeWind, and Commons proposed a solution that involves modification of JIB called the Jejunocolic Shunt. The procedure involved connected the top part of the small intestine to the colon. This modification aimed to prevent diarrhea and other complications that were associated with Jejuno-ileal Bypass (JIB).

Jejunocolic Shunt was a success in terms of weight loss, however, the problems that plagued Jejuno-ileal bypass (JIB) was also present in Jejunocolic Shunt. Due to these complications, Jejunocolic Shunt was not popular and did not attain widespread adoption.

The invention of Gastric Bypass | Year 1967

In 1967, we saw the invention of Gastric Bypass Surgery by Drs. Edward Mason & Chikashi Ito. The doctors came up with the idea for a gastric bypass after they noted that patients who underwent partial gastrectomy for cancer lost a significant amount of weight. So re-engineered the procedure and tailored it for weight loss.

The duo stapled the stomach so that a small pouch is formed, and then bypassed it with the small intestine. This has two advantages. One was that the patient can only eat fewer amounts of foods because of the volume reduction in stomach volume. The second was that bypassing the intestine ensures that few calories were absorbed from the food.   

Again, Gastric Bypass showed very promising results when it came to weight loss, however, it was not without other health complications like vitamin deficiencies, anastomotic leaks, and anemia.

Subsequent modifications to Gastric Bypass

The initial Gastric Bypass surgery involved gastric trisection with ileostomy loop. The resulted in very bad bile reflux action. So the ileostomy loop was replaced with a Roux-en-Y loop. Gastric Bypass using a Roux-en-Y loop ensured proper bile passage and significantly reduced the complications associated with previous forms of gastric bypass surgeries.

The rise of Roux-en-Y loop Gastric Bypass (RYGBP)

In 1996, Drs. Scopinaro and Gianetta went on to establish the Roux-en-Y Gastric Bypass procedure. The procedure involves dividing the stomach into two – a smaller upper portion and a bigger lower portion. Then the small intestine is divided into two – the upper small intestine and the lower small intestine. The smaller upper portion of the stomach is connected to the lower smaller intestine. then the upper small intestine is connected lower down the lower small intestine so that enzymes from the small intestine mixes with the food. 

Nowadays, Roux-en-Y Gastric Bypass ­is the most famous among gastric bypass surgeries. During the development of this surgery, it was performed as an open surgery where a large cut is used to operate.

In 1994, Alan Wittgrove performed the first laparoscopic gastric bypass. In laparoscopic surgery, the gastric bypass is done through 5 – 6 small incisions on the stomach rather than one large incision.

Nowadays people have the option between Laparoscopic bypass and Open surgery. However, the final decision is made after accessing the patient’s physical conditions.

Modern bariatric procedures – Endoscopic sleeve Gastroplasty (ESG) 

The methods that we discussed till now are really effective at reducing body weight, however, they all involve medications and additional medical supplements. With the help of modern medical technologies, we are now able to induce weight loss in people suffering from obesity by the use of ESG or Endoscopic Sleeve Gastroplasty.

ESG is a modern bariatric procedure that does not depend on surgery or stomach removal for weight loss. The process is done using endoscopy, and the recovery time is reduced to just 24 to 48 hours. It is a modern alternative to decades-old methods that we currently use.

To know more about Endoscopic sleeve Gastroplasty (ESG), contact Be Better Bariatrics. We provide non-surgical bariatric treatments for weight loss. Take the first step towards a better lifestyle today!

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