Metabolic surgery: a concise overview and understanding of potential complications

Bariatric surgery, despite a relatively short history, has had a tremendous impact on the discipline of surgery. In addition, it has had a profound influence on the development of laparoscopic surgery and the treatment of the worldwide epidemic of obesity. Contrary to the expectations of the 1990s, that obesity surgery would converge into a single procedure, there has been a trend favouring the safest and least invasive surgery on the one hand, and a diligence towards the most effective and complicated surgery on the other hand. The latter, being the biliopancreatic diversion with duodenal switch, requires advanced laparoscopic skills and an experienced medical team. This review will focus predominantly on the laparoscopic Roux-en-Y bypass, a recognised procedure which is performed in 80% of patients going to theatre for bariatric surgery.