Griffen in 1977, utilizing a gastrojejunostomy, and Y-Roux reconstruction, while staying away from bile reflux, offered the benefit of a tension-free anastomosis

Griffen in 1977, utilizing a gastrojejunostomy, and Y-Roux reconstruction, while staying away from bile reflux, offered the benefit of a tension-free anastomosis.41 After further modifications (particularly according of keeping the pouch and the space from the respective loops), this system evolved right into a standard procedure in bariatric medical procedures, in the USA especially, due to its extremely favorable percentage between pounds part and decrease results.42 An additional noteworthy milestone in the introduction MV1 of bariatric surgery is biliopancreatic diversion which was developed by N. gastrectomy which is not the desired common procedure for bariatric surgery but certainly a stylish treatment option. It should be performed in a more standardized manner and with due regard to long term long-term results. in 1982. These developments experienced an equally strong impact on numerous vagotomy methods for denervation, which were used less, and less in ulcer surgery. Currently, the use of gastroduodenal ulcer surgery is limited to classical ulcer complications (hemorrhage, perforation, penetration, pyloric stenosis) and to exclude malignant tumors in instances of ulcers refractory to traditional treatment. The medical use of longitudinal gastric resection was consequently becoming increasingly insignificant soon after becoming established as a treatment option. This was accompanied by lack of adequate data or further relevant publications. (b) Development of longitudinal gastric resection in bariatric surgery A review of the essential methods in the historic development of bariatric surgery is helpful in order to understand how longitudinal gastric resection appeared as sleeve gastrectomy within the modern therapy options. Obesity surgery treatment started with purely malabsorptive methods, moved on to combined malabsorptive and restrictive methods, and finally consisted of primarily restrictive methods. The first published bariatric treatment was a malabsorptive jejunoileal bypass performed by A.J. Kremen and co-workers in 1954.37 Numerous modifications followed, particularly in respect of location and type of the anastomosis.38 A significant reduction in weight was accomplished. However, many of these procedures were accompanied by serious side effects (including diarrhea, hepatic cirrhosis, and electrolyte imbalance) and did not prevail in the long term.2,39 Gradually, bariatric interventions were increasingly focused on the stomach. Various methods were used to reduce gastric volume and activate satiety. Furthermore, a malabsorptive component was additionally used to create a gastrointestinal bypass. In 1967, E.E. Mason submitted the first statement of a gastric bypass after horizontal division of the belly with re-anastomosis of its proximal portion by the use of a raised jejunal loop.40 Again, several variations concerning pouch size or replacing division of the belly by applying a horizontal row of clip sutures followed. The Roux-en-Y gastric bypass published by W.O. Griffen in 1977, using a gastrojejunostomy, and Y-Roux reconstruction, while avoiding bile reflux, offered the advantage of a tension-free anastomosis.41 After further modifications (particularly in respect of placement of the pouch and the space of the respective loops), this technique evolved into a standard procedure in bariatric surgery, especially in the USA, because of its very favorable percentage between weight-loss and side effects.42 A further noteworthy milestone in the development of bariatric surgery is biliopancreatic diversion which was developed by N. Scopinaro in 1979. Biliopancreatic diversion is also a combination of a malabsorptive process and a restrictive component. Scopinaro combined horizontal gastric resection with closure of the duodenal stump and a gastrojejunostomy while developing a common tract by jejunoileostomy to exclude large portions of the small bowel (Fig.?5).43 Scopinaro initially varied the lengths of the three segments of the small bowel. Subsequently a common tract about 50?cm in length and an alimentary tract about 250?cm length became established.2,44 The disadvantages of the procedure include malassimilation of fat and deficiency syndromes such as those of protein, iron, or vitamins.44,45 Open in a separate window Fig.?5 In 1979, N. Scopinaro launched his process of biliopancreatic diversion. He performed horizontal partial resection of the belly with closure of the duodenal stump, gastrojejunostomy, and a jejunoileal anastomosis to produce an alimentary tract ( em AT /em ), a bilio-pancreatic tract ( em BPT /em ), and finally, a common tract ( em CT /em )99 In 1973, E.E. Mason and K.J. Printen reported the 1st purely restrictive process by incomplete horizontal division of the belly while forming a conduit on the side of the greater curvature. However, the technique did not gain wide acceptance because of poorly sustained weight-loss.46 Subsequent variations were used to accomplish MV1 a reduction.However, it should be performed in a more standardized manner and with due regard to future long-term results. Open Access This short article is distributed under the terms of the Creative Commons Attribution Noncommercial License which permits any noncommercial use, distribution, and reproduction in any medium, provided the original author(s) and source are credited.. was examined. Conversation Besides bariatric surgery modern sleeve gastrectomy offers one more so far largely neglected source: segmental and later on longitudinal gastric resection used in ulcer surgery. Experience and achievements from ulcer surgery simplified and facilitated development of sleeve gastrectomy which is not the desired common procedure for bariatric surgery but certainly a stylish treatment option. It should be performed in a more standardized manner and with due regard to long term long-term results. in 1982. These developments had an equally strong impact on numerous vagotomy methods for denervation, which were used less, and less in ulcer surgery. Currently, the use of gastroduodenal ulcer surgery is limited to classical ulcer complications (hemorrhage, perforation, penetration, pyloric stenosis) and to exclude malignant tumors in instances of ulcers refractory to traditional treatment. The medical use of longitudinal gastric resection was consequently becoming increasingly insignificant soon after becoming established as a treatment option. This was accompanied MV1 by lack of adequate data or further relevant publications. (b) Development of longitudinal gastric resection in bariatric surgery A review of the essential methods in the historic development of bariatric surgery is helpful in order to understand how longitudinal gastric resection appeared as sleeve gastrectomy within the modern therapy options. Obesity surgery started with purely malabsorptive procedures, moved on to combined malabsorptive and restrictive methods, and finally consisted of mainly restrictive methods. The first published bariatric treatment was a malabsorptive jejunoileal bypass performed by A.J. Kremen and co-workers in 1954.37 Numerous modifications followed, particularly in respect of location and type of the anastomosis.38 A significant reduction in weight was accomplished. However, many of these procedures were accompanied by serious side effects (including diarrhea, hepatic cirrhosis, and electrolyte imbalance) and did not prevail in the long term.2,39 Gradually, bariatric interventions were increasingly focused on the stomach. Numerous methods were used to Ifng reduce gastric volume and activate satiety. Furthermore, a malabsorptive component was additionally used to create a gastrointestinal bypass. In 1967, E.E. Mason submitted the first statement of a gastric bypass after horizontal division of the belly with re-anastomosis of its proximal portion by the use of a raised jejunal loop.40 Again, several variations concerning pouch size or replacing division of the belly by applying a horizontal row of clip sutures followed. The Roux-en-Y gastric bypass published by W.O. Griffen in 1977, using a gastrojejunostomy, and Y-Roux reconstruction, while avoiding bile reflux, offered the advantage of a tension-free anastomosis.41 After further modifications (particularly in respect of placement of the pouch and the space of the respective loops), this technique evolved into a standard procedure in bariatric surgery, especially in the USA, because of its very favorable percentage between weight-loss and side effects.42 A further noteworthy milestone in the development of bariatric surgery is biliopancreatic diversion which was developed by N. Scopinaro in 1979. Biliopancreatic diversion is also a combination of a malabsorptive process and a restrictive component. Scopinaro combined horizontal gastric resection with closure of the duodenal stump and a gastrojejunostomy while developing a common tract by jejunoileostomy to exclude large portions of the tiny colon (Fig.?5).43 Scopinaro initially varied the measures from the three sections of the tiny colon. Subsequently a common tract about 50?cm long and an alimentary tract about 250?cm length became established.2,44 The drawbacks of the task include malassimilation of fat and insufficiency syndromes such as for example those of proteins, iron, or vitamins.44,45 Open up in another window Fig.?5 In 1979, N. Scopinaro released his treatment of biliopancreatic diversion. He performed horizontal incomplete resection from the abdomen with closure from the duodenal stump, gastrojejunostomy, and a jejunoileal anastomosis to generate an alimentary tract ( em AT /em ), a bilio-pancreatic tract ( em BPT /em ), and lastly, a common tract ( em CT /em )99 In 1973, E.E. Mason and K.J. Printen reported the initial purely restrictive treatment by imperfect horizontal division from the abdomen while developing a conduit privately of the higher curvature. Nevertheless, the technique didn’t gain wide approval because of badly sustained fat loss.46 Subsequent variations had been used to attain a reduced amount of gastric volume but weren’t successful because of dilatation from the gastric pouch.2,38 This issue was solved in 1982, by E again.E. Mason, who introduced vertical gastroplasty with creation of the pouch in the relative side from the lesser curvature.