The very first bariatric procedure was done in 1954 by Kremen, Linner, and Nelson.8 They performed a jejunoileal bypass to exclude a sizable segment of small bowel. This decreases the capacity to absorb a lot of the nutrients consumed. Bypasses of the nature grew out of favor because patients complained of uncontrollable diarrhea and suffered from dehydration and electrolyte imbalances. Jejunoileal bypass was revised in 1996 to a biliopancreatic diversion by Scopinaro et al.9 Biliopancreatic diversion produces its weight-loss effect mainly by malabsorption, but it addittionally carries a small restrictive aspect. The intestinal reconfiguration promotes malabsorption of fat and protein. Patients often lost and maintained a significant number of weight but suffered from ulcers, foul-smelling flatus and stool, protein malnutrition, and iron-deficiency anemia. Protein malnutrition is the absolute most serious potential complication of biliopancreatic diversion and may be connected with hypoalbuminemia, anemia, edema, asthenia, and alopecia. Treatment often requires hospitalization with hyperalimentation. The duodenal switch, first presented by Hess and Hess10 in 1998, is just a modification of the biliopancreatic diversion that reduces the severity of protein calorie malnutrition, decreases the incidence of dumping syndrome, and prevents ulcers. Gastric bypass is just about the gold standard of weight-loss surgery. Mason and Ito11 in 1967 developed the principles of gastric bypass surgery when they pointed out that women who’d undergone partial gastrectomy for peptic ulcer disease often were underweight and had difficulty gaining weight. Vertical-banded gastroplasty first reported in 1982 by Mason12 grew in popularity with the advent of mechanical staplers. It had been thought to be a safer alternative to gastric bypass. It had been the very first purely restrictive operation performed for the treating obesity. A bag is established on the lesser curvature of the stomach, and a polypropylene mesh band is put across the pouch outlet. There are very few complications attributed to this procedure because no anastomosis is created. Hess and Hess13 later described the first laparoscopic vertical-banded gastroplasty. Vertical-banded gastroplasty went out of favor because patients are not able to maintain weight loss.

Another purely restrictive bariatric procedure is nonadjustable gastric banding. This procedure was first described in 1978 by Wilkinson and Peloso,14 who placed a 2-cm Marlex mesh around the top of the main stomach, separating the stomach right into a small upper pouch and the remainder of the stomach. This procedure failed secondary to pouch dilation, causing poor weight loss. It absolutely was revised in 1986 by Kuzmak,15 who used a 1-cm Silicone band to encircle the stomach. This created a 13-mm stoma and a 30- to 50-mL proximal gastric pouch. The band was then modified by inserting an inflatable balloon to adjust the band and stoma size.

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