Bariatric and Metabolic Surgery Indications, Complications and Revisional Procedures

of genetic predisposition, environmental influences (e.g., sedentary lifestyle), and behavioral components. Obesity has become a pandemic affecting billions of people worldwide. Being overweight and obese are well-known causes of morbidity and mortality, with significant health, social and economic implications, due to the cost of the many comorbidities that are often associated. Bariatric surgery is currently considered the most effective treatment option for morbid obesity. When compared with nonsurgical interventions, bariatric surgery results in greater improvements not only in weight loss outcomes but also in obesity-related comorbidities. The aim of bariatric surgery has therefore been upgraded from a merely weight-loss surgery to a metabolic surgery. Different surgical options are currently available and they are continuously evolving under the influence of the literature results, specific local conditions, and the experience of the surgical staff in each country. Through 20 chapters this book offers a summary of all the aspects of bariatric and metabolic surgery, illustrating the evolution of bariatric surgery in Italy and worldwide and describing the indications, surgical technique, and complications of all the most commonly performed bariatric procedures. Unfortunately, a certain percentage of the operations performed is associated with inadequate weight loss or anatomic complications due to multiple concurrent factors. Therefore, bariatric surgeons are now routinely facing an increasing number of patients who need a second or third obesity procedure: the so-called “revisional surgery”. In fact, three chapters are dedicated to this topic and deal with the clinical and surgical management of this emerging class of patients. Last chapters focus on some “hot topics” in bariatric surgery – such as diabetes surgery and the problem of gastroesophageal reflux disease and hiatal hernia – and provide an overview of the endoluminal procedures and some other bariatric procedures. A wide range of healthcare professionals (bariatric surgeons, general surgeons, psychologists, and gastroenterologists) have been involved in the writing of these chapters because I firmly believe that a multidisciplinary team is essential for the management of obesity.I would like to express my gratitude to all the colleagues who contributed to the preparation of this book, which will hopefully serve as a useful manual for a wide range of healthcare professionals. Naples, September 2016 - Luigi Angrisan