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Invited Critique
December 1, 2005

Accelerated Growth of Bariatric Surgery With the Introduction of Minimally Invasive Surgery—Invited Critique

Arch Surg. 2005;140(12):1203. doi:10.1001/archsurg.140.12.1203

Nguyen et al1 have brought to light informative data concerning the recent progress made in marshaling our surgical workforce resources to meet the tsunami of morbid obesity, which is at the leading edge of morbidity and mortality in the national obesity epidemic. Surgical intervention has proved to be the most effective method in achieving prolonged weight loss and reversing metabolic comorbidities in morbidly obese patients. This can be effectively done using either open or minimally invasive surgical techniques.2 The evolution of minimally invasive or laparoscopic surgical techniques for bariatric surgery has created a tremendous surge in enthusiasm among patients, primary care physicians, and surgeons. Bariatric surgery is no longer shunned as it once was in the 1970s and 1980s. The resurgence in and acceptance of the surgical treatment of morbid obesity were led by the evolution of a better bariatric operation: the current version of the Roux-en-Y gastric bypass. This, along with the advent of advanced minimally invasive techniques in the 1990s, led by Wittgrove et al3 and other surgeons, in conjunction with a national outcry from morbidly obese individuals, led by patient celebrities, has resulted in the exponential increase in laparoscopic approaches to treat morbid obesity.

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