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Introduction

The word bari’ is the plural of ‘baros’. In Greek, “baros” means weight/ burden/ load or heaviness. From this stems “Baris” referring to the obese or fat/heavy/overweight people.  

Surgeons first began to recognize the potential for surgical weight loss while performing operations that required the removal of large segments of a patient's stomach and intestine. Bariatric surgery has continually evolved since its initial sporadic and tentative introduction in the 1950’s. The first bariatric procedure to be preceded by animal studies and subsequently recognized by the surgical society was that of jejuno-ileal bypass (JIB) by Kremen and associates in 1954. Jejuno-ileal bypass involved joining the upper small intestine to the lower part of the small intestine as an end-to-end or end-to-side anastomosis, thus bypassing a large segment of the small bowel, which is thus taken out of the nutrient absorptive circuit. This procedure was associated with an array of early and late complications. These primitive procedures have been continually refined, in order to improve results and minimize risks.

 

Today's bariatric surgeons have access to a substantial body of clinical data to help them determine which surgeries should be used and why.

Today, Society for Bariatric Surgery describes two basic approaches:

  • Restrictive procedures that decrease food intake.  
  • Malabsorptive procedures that alter digestion, thus causing incomplete absorption of food.