Weight loss surgery in America has a 60 year history. It begins just after World War II, when the first dedicated weight loss surgery – a now-obsolete procedure called a jejunoileal bypass – was performed in 1954 at the University of Minnesota by Dr. A.J. Kremen.
Over the following decade, physicians began to notice that patients undergoing partial stomach removal for ulcers also experienced quick weight loss. This realization led to the first modern gastric bypass operation (the Ito-Mason gastric bypass), which was performed in 1967. In this “classic” gastric bypass operation, the stomach is separated into a small upper pouch and a larger, lower “remnant”. Both are then connected to the small intestine. The functional volume of the stomach is significantly reduced by this process, which alters the patient’s physiological and psychological response to food.
Gastroplasty, or “stomach stapling”, was implemented in the early 1970s after the introduction of mechanical tissue staplers. In this procedure, the stomach is stapled to form two portions, with a tiny opening for food to pass between the two. This type of gastroplasty was abandoned due to its ineffectiveness over the long term. Vertical banded gastroplasty (VBG), a related procedure employing a mesh band or silicone ring instead of stapled tissue, is now the accepted standard gastroplasty. However, due to the severe heartburn and relatively rapid weight regain associated with this procedure, it is rarely performed today.
With the dawn of the 1980s came the rise of weight loss surgery technology over technique. The first gastric band was developed by the late Dr. Lubomyr Kuzmak in 1983. The original Dacron band (with a buckle!) was soon replaced by a silicon rubber band lined with an inflatable balloon in 1986. This balloon-like band is placed around the top of the patient’s stomach, then tightened by the injection of a saline solution into the band’s balloon-like inner layer. This creates a small stomach pouch that restricts food intake, and thus causes weight loss.
Although performed in Europe since its invention, adjustable gastric banding was not practiced in the United States until the Food and Drug Administration (FDA) approved the use of the Lap-Band
