In the past, gastric bypass has been regarded by many medical experts as the recommended standard, and it was by far the most frequently chosen procedure. In 2003, Roux-en-y gastric bypass accounted for 85% of all bariatric surgeries performed. In part this is because gastric bypass surgery has been available since the 1970s and thus has a more proven track record. It is also covered by most insurance companies as an effective treatment for morbid obesity. Laparoscopic band surgery, on the other hand, was only approved in the U.S.
According to Buchwald and Olen, however, in 2008 laparoscopic adjustable gastric banding accounted for more than 42% of bariatric operations, making it the top surgical approach in their study. Laparoscopic standard Roux-Y gastric bypass was a close second, at 39.7%, while non-laparoscopic RYGBs accounted for another 5.7% and total sleeve gastrectomies for 4.5%.
These trends contrast surprisingly with the answers given by respondents to a poll recently conducted on WeightLossSurgeryChannel. The survey asked readers:
"What type of WLS did you have or are you considering?"
The results show some very interesting differences from the statistical findings about which procedures are most common. Among this group, gastric bypass still maintains its 65% share of the market, with Lap Band/REALIZE gastric banding a fairly distant second, with 22% of the vote.
Since the WeightLossSurgeryChannel poll included people still considering surgery as well as those who had already made their choice and undergone a procedure, it perhaps reflects a middle ground between popular awareness, which may still favor gastric bypass, and actual practice, which is apparently trending toward gastric banding.
In the years since the National Institutes of Health Consensus Conference declared that “weight reduction may be life saving for patients with extreme obesity," both the popularity and frequency of surgical approaches to weight loss have grown exponentially.
From 1998 to 2002, the number of bariatric surgeries increased as much as 400 percent, with an estimated 85,000 inpatient surgeries performed in 2002. By 2008, that number had risen another 400 percent. According to a report by Henry Buchwald and Danette Olen on "Metabolic/Bariatric Surgery Worldwide 2008" published in the December 2009 issue of Obesity Surgery, in 2008, 344,221 bariatric surgery operations were performed worldwide, the majority of them in the United States and Canada (220,000).
According to another survey by Thomson Healthcare, much of this increase is due to a big increase in the number of outpatient surgeries and also to the development of laparoscopic techniques for both inpatient and outpatient surgeries. In fact, by 2008 over 90% of procedures were being performed laparoscopically. Outpatient laparoscopic procedures more than doubled between 2006 and 2008.
These numbers reflect the rapid pace of development and change in both the attitudes about and the techniques available for weight loss surgery, which are combining to make the surgery even more acceptable, available, and convenient, as well as safer.