Obesity Surgery in Spain

Special Article – Obesity Surgery in Spain

Austin J Surg. 2020; 7(2): 1243.

Obesity Surgery in Spain

Aniceto Baltasar*

San Jorge Clinic, 55 Oliver, Alcoy, Spain

*Corresponding author: Aniceto Baltasar, San Jorge Clinic, 55 Oliver, Alcoy, Spain

Received: February 06, 2020; Accepted: March 09, 2020; Published: March 16, 2020

Abstract

Gastric obesity surgery (OS) from the Greek bari = weight and iatrein = cure) treats obesity and began in Spain in 1977. Its greatest development occurs after the founding of SECO (Spanish Society of Obesity Surgery) in 1997. The purpose of this work is to reflect the changes that have occurred in these 23 years.

Keywords: Morbid obesity; Bariatric surgery; SECO

Abbreviations

VBG: Vertical Banded Gastroplasty; GB: Gastric Banding; RYGBP: Roux-en-Y Gastric By Pass;

OAGB: One Anastomosis GBP/mini GBP; BPD: Bilio-Pancreatic Diversion; ID: Intestinal Diversion; DS: Duodenal Switch; SADI: Single Anastomosis Duodenal-Ileostomy; SFG: Sleeve-Forming Gastrectomy; ABS: Adolescent Bariatric Surgery; ABS: Adolescent Bariatric Surgery; REV: Revision/Conversion of Prior Surgery; MO: Morbid Obesity; WL: Weight loss; %EWL: % Excess Weight Loss; L: Laparoscopic

Introduction

Obesity is a multifactorial epidemic ailment of environmental origin, affecting subjects from all countries. The surgical treatment represents a unique case of surgery to operate on healthy organs, which are not the cause of the disease and do not improve after the operation.

Kremen & Linner [1] and Varco & Buchwald in Minneapolis, MN teams began the malabsorptive intestinal diversion (ID) in 1954. Payne [2] and Scott [3] developed these ID techniques in the 1960s leaving only 14-4 inches (35-10 cm) as an absorptive zone and those were abandoned in the 1970s because of their serious metabolic (malnutrition) and hepatic (liver failure) complications.

Historical keynote

Cordoba (Qurtuba in Arabic) was the most civilized city in Europe in the 10th Century. Andalusia was home to the most famous physicians of the Middle-Ages, Averroes (1126-1198) and Maimonides (11351204). Sancho “the Fat”, King of León 956-958, was deposed due to his massive obesity that unable him to ride a horse. He found safety in Pamplona, in the Navarre Kingdom 400 km from León, where his grandmother, Queen Toda, ruled. Toda’s aim was to regain the kingdom of León for her grandson, but this was impossible unless Sancho the Fat lost his massive excess weight. Hasdai ibn Shaprut was a famous Jewish physician at Cordoba’s Abdurrahman III’s court. He travelled to Pamplona to evaluate Sancho super-super-obesity and decided that he would only treat him if he came to Cordoba. The 800-km trip was an ordeal because Sancho could not ride a horse or fit into a carriage. He remained semi-conscious for most of the trip and was carried in a special canvas tent, devised by Hasdai, between four mules. The queen, Toda (Abdurrahman III’s aunt), Garcia (her son, the king of Navarre) and Sancho lived in Cordoba for 6 months, during the time that the treatment lasted. The treatment consisted of suturing Sancho’s lips together and feeding him only through a straw. Sancho lost half his weight, returned to León riding a horse, and was able to regain his kingdom in 959 Baltasar (AB) [4].

First Spanish experience

Prof. Sebastián García Díaz of Seville carried out the 1st Scotttype Jejune-ileal diversion (JID) at Virgen Macarena Hospital on 11.19.1973. He began ID surgery in Spain with 12 cases [5-7] and then published 20 more, and the 1st work in English by a Spanish author [8] in 1981. His works went unnoticed for 40 years until we rescued them in 2013 [9] (Figure 1).