Department of General Surgery, Leicester Royal Infirmary, Leicester, UK.
J Surg Res. 2013 Aug;183(2):559-66. doi: 10.1016/j.jss.2013.02.036. Epub 2013 Mar 14.
Obesity is a pandemic associated with significant morbidity and mortality. This historical article charts the progress of successful strategies that have been used to tackle weight loss from dietary modifications to the development of surgical interventions that have subsequently evolved. It also provides a précis of the reported outcome data following minimally invasive bariatric procedures.
A literature review was performed. All articles relevant to the progression of bariatric surgery and minimally invasive surgery were assessed, as were those articles that described the ultimate evolution, combination, and establishment of the two techniques.
This article charts the progression of early weight loss strategies, from early dietary modifications and pharmacologic interventions to initial techniques in small bowel bypass procedures, banding techniques, and sleeve gastrectomies. It also describes the simultaneous developments of endoscopic interventions and laparoscopic procedures.
A range of procedures are described, which differ in their success in terms of loss of excess weight and in their complication rates. Weight loss is greatest for biliopancreatic diversion followed by gastric bypass and sleeve gastrectomy and least for adjustable gastric banding. Bariatric surgery is an evolving field, which will continue to expand given current epidemiologic trends. Developments in instrumentation and surgical techniques, including single access and natural orifice approaches, may offer further benefit in terms of patient acceptability.
肥胖是一种与重大发病率和死亡率相关的全球性问题。本文追溯了成功应对减肥的策略的发展历程，从饮食调整到外科干预的发展，这些策略都取得了显著成效。本文还简要介绍了微创减重手术后的报告结果数据。
进行了文献回顾。评估了与减重手术和微创手术进展相关的所有文章，以及描述这两种技术的最终演变、结合和确立的文章。
本文描述了早期减肥策略的发展历程，包括早期的饮食调整和药物干预，以及小肠旁路手术、带术和胃袖切除术等初步技术。同时，还描述了内镜干预和腹腔镜手术的同步发展。
本文描述了多种手术方法，它们在减轻多余体重的效果和并发症发生率方面存在差异。减重效果最好的是胆胰分流术，其次是胃旁路术和胃袖切除术，而可调胃束带术的效果最差。鉴于当前的流行病学趋势，减重手术是一个不断发展的领域，将继续扩大。器械和手术技术的发展，包括单通道和自然腔道技术，可能会在患者接受程度方面带来进一步的益处。
