Minimally invasive gastrojejunal bypass is the “golden standard” in bariatric surgery of morbid obesity

Abstract

INTRODUCTION Morbid obesity became major health problem in the US and growing worldwide becoming a pandemic. More than 10 million people are currently morbidly obese in the USA 1 . Severe obesity places a large financial burden on the health care system due to co-morbid conditions such as diabetes mellitus, obstructive sleep apnea, hypertension, hyperlipidemia, degenerative joint disease and certain cancers. Dietary measures have poor results with only a 1% success rate for long term weight maintenance. Bariatric surgery offers the only effective treatment for life. The National Institute of Health consensus conference on obesity in 1991 recommended surgical treatment as an option for patients with BMI over 40 and for those with BMI over 35 with obesity related co-morbidities. Recent new surgical techniques improved perioperative care made bariatric surgery safe, widely accepted and popular. In 2020 more than 250 000 bariatric operations were performed in the US. With worldwide increase of these operations, the medical community and health insurance companies are becoming more familiar and supportive of bariatric surgery. Currently, 64 % of the US population and 42% in Ukraine are overweight or obese. Obesity is now recognized as a disease that has spread throughout the world in the form of a pandemic 2 . This disease in most cases for life, there are no reliable ways of drug treatment for it, often there are medical, cosmetic and psychological problems (depression, turmoil in family life, low self-esteem, infertility, etc.).This disease shortens life due to the accompanying pathological conditions (type 2 diabetes, hypertension, cardiovascular complications, thromboembolism, etc.), and also increases