De la chirurgie bariatrique à la chirurgie métabolique : une histoire en devenir Partie 1. L'histoire de la chirurgie bariatrique

Bariatric surgery was designed to treat super-obesity 60years ago. Its initial development based on jejuno-ileal and jejuno-colic bypasses accounted forsevere complications. Thereafter procedures have evolved along three lines: restrictive that interfere with intake of calories, malabsorptive that interfere with their absorption, and a combination of these two approaches. Aftera period ofdoubtand disappointment, bariatric surgery which clearly benefits from the growing of laparoscopic surgery, isnow considered as a second line treatment of morbid obesity. Purely restrictive procedures were becoming morepopularwith a favorable benefit/risk ratio. A better understanding of obesity and its mechanisms, mainly hormonal and neuralpathways of regulating appetite and satiety will help to develop safer and more efficient procedures in the future.