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A Brief History of Bariatric Surgery

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Bariatric surgery has gained popularity in recent years as an alternative to weight-loss diets. More and more people are turning towards this procedure to decrease their excess weight. The history of bariatric surgery can be traced back to the 1950s. Many innovations and improvements have been made since to make the procedure safer.

The first bariatric surgery was performed in 1954, by a surgeon named A. J. Kremen. This procedure was then called intestinal bypass. The upper and lower regions of the small intestine were linked together to bypass the middle section, where most of food absorption takes place. The idea was to decrease the amount of food processed by the intestine so that the body absorbs fewer calories. A similar procedure was developed by a Swedish physician at about the same time. Here, the redundant portion of the small intestine was removed. Many more methods of bypassing the digestive and absorptive sections have also been tried by surgeons. However, patients on whom the surgeries were performed developed complications such as dehydration, diarrhea, and electrolyte imbalance. Intestinal modification was therefore abandoned, and safer bariatric surgeries involving the stomach were introduced to do away with earlier complications.

Gastric bypass was developed in 1966, by Dr. Edward E. Mason of the University of Iowa. He used surgical staples to create a partition across the upper stomach. This partition reduces the intake of food. The pouch that is created gives patients a feeling of fullness, even when they eat a small amount of food. The procedure was called vertical banded gastroplasty. Though there were complications in the initial procedure, further refinements were made; the pouch created by stapling the upper stomach was reduced in size to further reduce food intake, and elastic bands were used later instead of staples. While this method proves effective initially, the band tends to stretch after a few years. This form of bariatric surgery, therefore, failed to gain wide popularity.

A later innovation in the field of bariatric surgery was the Roux-en-Y gastric bypass, which combined the principles of gastric restrictions and dumping syndrome. Here, the surgeon creates a pouch by stapling the upper stomach and attaching it to the small intestine. The small pouch, about the size of a thumb, causes reduced intake of food and less digestion of food. Roux-en-Y gastric bypass has gained popularity owing to the relatively few complications involved. Many different types of bariatric surgeries were developed later. Currently, there are eight different types of bariatric surgery performed in most state-of-the-art hospitals across the United States.


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