| Abstract: |
Obesity is the excessive accumulation of adipose tissue to an extent that health is impaired; it becomes one of the major risks to health affecting the world’s population (Aronne et al., 2002). It is termed ”morbid” when it reaches the point of significantly increasing the risk of one or more obesity-related health conditions or serious diseases, Health consequences are categorized as being the result of either increased fat mass (osteoarthritis, obstructive sleep apnea) or increased number of fat cells (diabetes, cardiovascular diseases, fatty liver disease), (Bray., 2004).Obesity is a complex disease for which no single cause or cure exists. You gain weight when you take in more calories than you burn off. But obesity is influenced by many other factors as well: sedentary life, genetics, medical illness and many hormonal mechanisms have been elucidated that participate in the regulation of appetite and food intake, storage patterns of adipose tissue and development of insulin resistance e.g. leptin and ghrelin(Encinosa et al., 2006). Obesity is typically evaluated in absolute terms by measuring body mass index (BMI) but also in terms of its distribution through waist circumference or waist-hip circumference ratio measurements (Enserer etal., 2004).The non-surgical approaches through reduced caloric intake and increased physical activity, combined with behavioral modification and pharmacotherapy are effective approaches for weight management, however these measures with morbid obesity generally fails to produce long term weight loss ,since several bariatric surgical techniques have been developed (Flier., 2005).Bariatric surgery is known to be the most effective and long lasting treatment for morbid obesity and many related conditions, but now mounting evidence suggests it may be among the most effective treatments for metabolic diseases and conditions including type 2diabetes, hypertension, high cholesterol, non-alcoholic fatty liver disease and obstructive sleep apnea (Jama., 2004). Weight loss operations fall into three categories: Restrictive procedures, Malabsorptive procedures & Combination operations employ both restriction and malabsorption. Open and laparoscopic approaches refer to how abdominal cavity is entered and not the type of surgery being performed; both approaches have similar surgical principles, and effect on excess weight loss (Morino et al., 2004).Laparoscopic approach has clear advantages over open approach, such as a reduction in abdominal wall complications and a shorter hospital stay, however laparoscopic techniques of bariatric surgery have a more complex learning curve than other laparoscopic techniques, which may be associated with an increase in postoperative complications (Sweeting., 2007).
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