The optimal surgical management of the super-obese patient: The debate

Eric J. DeMaria, Philip Schauer, Emma Patterson, Ninh T. Nguyen, Brian P. Jacob, William B. Inabnet, Henry Buchwald

Research output: Contribution to journalReview articlepeer-review

48 Scopus citations


Optimal management of the super-obese patient (body mass index >50 kg/m2) undergoing weight loss surgery in the new era of laparoscopic treatment is more controversial than ever before. Newer laparoscopic options for treatment of the super obese, including laparoscopic adjustable gastric banding, sleeve gastrectomy, and staging of gastric bypass, are technically easier and may be safer. Concerns that weight loss may be suboptimal or that the procedures will require revision, or both, make these choices controversial. Open access/conversion for established procedures such as long-limb gastric bypass and biliopancreatic diversion with or without duodenal switch are the traditional alternatives when laparoscopic access fails or is deemed too difficult to undertake. The following debate was presented by invited experts in laparoscopic and open bariatric surgery at the 2005 Annual Meeting of the Society of American Gastrointestinal and Endoscopic Surgeons in Florida. The presenters put forth arguments for the various modern options for treatment of the super obese, which are presented in written form. Interactive audience response technology provided a mechanism for polling the audience before and after the presentations. A review of the audience's responses provides insight into the decision-making considerations of a population of laparoscopically oriented bariatric surgeons.

Original languageEnglish
Pages (from-to)107-121
Number of pages15
JournalSurgical Innovation
Issue number2
StatePublished - Jun 2005


  • Laparoscopic adjustable gastric banding
  • Sleeve gastrectomy
  • Staged gastric bypass
  • Super-obese patients

ASJC Scopus subject areas

  • Surgery


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