Laparoscopic bariatric surgery.
Laparoscopy has meant profound changes for the field of bariatric surgery. Bariatric operations, which are technically difficult because of the patient population, were not performed laparoscopically until the last 5 years of the 20th century. The years 1998 to 2003, herein defined as the Bariatric Revolution, saw profound changes in the way bariartric surgery was practiced. Major changes in patient education, public awareness, patient enthusiasm, popularity of the surgery, and academic acceptance of bariatric surgery occurred during this time. This led to such a massive increase in procedures performed that there was a reactionary movement by insurers to deny coverage for these procedures. Limitation of access to care and other important socioeconomic issues are now being debated and confronted in the bariatric arena. Recommendations for the field are suggested. The outcomes of these controversies will potentially have a profound impact on all of surgery.
Schirmer
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Dept. of Surgery, Health Sciences Center, Box 800709, Charlottesville, VA 22908, USA. bs@virginia.edu
D050110:Bariatric Surgery / Q000009:adverse effects / Q000191:economics / Q000379:methods* / Q000523:psychology / Q000706:statistics & numerical data / Q000639:trends; D005544:Forecasting; D015390:Gastric Bypass / Q000009:adverse effects / Q000706:statistics & numerical data; D015391:Gastroplasty / Q000379:methods / Q000523:psychology / Q000706:statistics & numerical data; D006297:Health Services Accessibility; D006801:Humans; D006949:Hyperlipidemias / Q000601:surgery; D019458:Insurance Coverage; D007581:Jejunoileal Bypass / Q000009:adverse effects; D010535:Laparoscopy / Q000191:economics / Q000379:methods / Q000523:psychology / Q000706:statistics & numerical data / Q000639:trends; D008286:Malabsorption Syndromes / Q000209:etiology / Q000517:prevention & control; D019060:Minimally Invasive Surgical Procedures; D009767:Obesity, Morbid / Q000601:surgery; D010342:Patient Acceptance of Health Care; D011183:Postoperative Complications / Q000209:etiology / Q000517:prevention & control; D012657:Self-Help Groups; D012955:Societies, Medical / Q000706:statistics & numerical data; D013043:Specialties, Surgical; D017792:Surgical Stapling; D016896:Treatment Outcome