Techniques of laparoscopic gastric bypass

Obesity has been recognized as a growing national and international epidemic. Weight-related health complications contribute to a tremendous cost to society as well as to the obese patient (1). It is now estimated that being overweight is second only to tobacco as a leading cause of death in the United States (2). The gastric bypass has undergone numerous modifications since its conception by Mason and Ito (3). This evolution ultimately led to the application of laparoscopic techniques described first by Wittgrove and Clark in the 1990s (4,5). When compared to the open approach, patients undergoing laparoscopic gastric bypass benefit from a lower incidence of incisional hernia, wound infection, and pulmonary complications, as well as from diminished pain, shorter hospitalization, and a more rapid return to the activities of daily living and work (6,7).