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The field of bariatric surgery has changed rapidly in the past two decades, and guiding patients toward the appropriate procedure for their clinically severe obesity is complex. Here, the authors review bariatric surgical procedure options, including sleeve gastrectomy, Roux-en-Y gastric bypass, and biliopancreatic diversion with or without duodenal switch, evidence on procedure safety and efficacy, and other factors that can influence patient choice of one procedure over another. Shared decision-making in the context of patients' acceptance of treatment risk, medical problems, weight loss expectations, eating behaviors, and mental health are discussed along with reasons for undergoing bariatric surgery. Priorities of weight loss, such as type 2 diabetes resolution, play a role in surgical choice and assessment tools like the Individual Metabolic Surgery score exist to aid in selection of a procedure according to a patient's diabetes severity. Through a series of prepared medical visit vignettes, the authors provide insights for how providers might guide conversations about surgical choice with their patients, carefully balancing patient preference with their own perceptions of which bariatric surgery will result in optimal improvements in physical and mental health. [ABSTRACT FROM AUTHOR]

The article presents the author's view regarding his contribution to the evolution of the medical practice known as bariatric surgery. Topics discussed include the author's participation in the Nutrition Support Service division of the Deaconess Hospital in the 1970s, his support to the introduction of the Roux-en-Y-gastric bypass technique in surgery, and the development of the continuing medical education program on obesity surgery at Harvard University.

The article focuses on the history of bariatric surgery that was introduced in 1975. It mentions that biliopancreatic diversion (BPD) have adverse effects with the information on gastric banding (GB). It offers information on the Center for Surgical Treatment of Obesity (CSTO), specialized in performing surgery for obesity and reconstructive operation.

Abdominal pain is a common presentation following Roux-en-Y gastric bypass and bilio- pancreatic diversion-duodenal switch procedures. Causes of abdominal pain are diverse in this patient population, and some may warrant an urgent intervention. We have reviewed current literatures using PubMed, and added our experience to list the causes of abdominal pain after Roux-en-Y gastric bypass and bilio-pancreatic diversion- duodenal switch. Thorough history taking and review of clinical signs are important when a patient presents with abdominal pain. Surgical exploration is necessary and more common in this patient population, if the diagnosis cannot be made using non-invasive measures. [ABSTRACT FROM AUTHOR]

We present a case of a patient who presented to our facility in Baltimore, Maryland, with emergent complications following revisional bariatric surgery (sleeve gastrectomy to biliopancreatic diversion with duodenal switch), which was performed outside of the United States. Upon further investigation, we discovered Roux-en-O, a rare surgical complication in which the Roux-en-Y is misconfigured and results in improper connection of the biliopancreatic limb to the gastric pouch. We suspected that the surgical errors were probably initiated by a misperception of the ends of the Roux and biliopancreatic limbs, which cascaded into further confusion of the common channel and Roux limb channel. Here, we discuss signs and symptoms, diagnosis, and treatment of a Roux-en-O misconfiguration and make recommendations for developing a routine to consistently track the proximal Roux limb. [ABSTRACT FROM AUTHOR]

The article discusses obstructive sleep apnea syndrome in bariatric patients. Topics discussed include diagnosis and pathophysiology of the syndrome in obese patients, use of continuous positive airway pressure in patients for first-line treatment of the syndrome, bariatric surgical procedure for treatment of sleep apnea, and mentions efficacy of biliopancreatic diversion (BPD) in treatment.

The article focuses on the court case Mettias v. United States. Topics discussed include an overview of the court case and the final ruling of the U.S. Federal Court, and the potential impact of the federal court's ruling on the standards adopted by the medical community regarding the eligibility of patients for bariatric surgery. The article also presents a questionnaire provided by the journal "Bariatric Times" for its opinion survey regarding the court case.

An introduction is presented in which the editor discusses various articles in the June 2015 issue of the journal "Bariatric Times" on topics including the history of bariatric surgery and surgical fellowship.

The article presents the author's view regarding the article "The History of Bariatric Surgery-As Told by the Leaders Who Made It Happen" which was published in the journal "Bariatric Times".