by Sherif Hakky, MBBS, MSc, MRCS;
Matthew Thompson, MBBS, BSc; and
Ahmed R. Ahmed, MBBS, BSc(Hons), FRCS

Department of Bariatric Surgery, Imperial College Healthcare, Charing Cross Hospital,  London, United Kingdom

INTRODUCTION
Bariatric surgery in the United Kingdom (UK) has grown and adapted over recent years to meet the new demands imposed by an ever-increasing rise in clinical obesity. This process has been promulgated through growing evidence of the clinical benefits of surgery as well as advantageous health economics favoring surgery. The lack of successful lifestyle and pharmaceutical therapies to treat obesity along with the financial burden imposed on a free access healthcare system (the National Health Service—NHS) through obesity-related disease have further perpetuated these changes.
There are many success stories and a mounting evidence base that make bariatric surgery an exciting field in the UK at present.
There exists the potential to cure diabetes, hypertension, hypercholesterolemia and sleep apnea while also dramatically reducing the risk of a large number of other diseases including some cancers thus providing an overall survival benefit.[1–3] This is something no other speciality can boast.

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Ariel U. Spencer, MD; Thomas H. Magnuson, MD, FACS; Hien Nguyen, MD; Kimberley E. Steele, MD, FACS; Anne O. Lidor, MD, FACS; and
Michael A. Schweitzer, MD, FACS.

From The Johns Hopkins Medical Institutions, Baltimore, Maryland

Introduction
Staple line buttress material—either absorbable or permanent—is widely used in bariatric surgery. While many surgeons have anecdotal experience with a particular material, this review will examine the data currently available to support the use of buttress material, the indications for its use, and possible advantages of specific types of material, based on current human and animal studies.

Most bariatric surgical procedures—with the exception of adjustable gastric banding—require the creation of staple lines along the margins of gastric pouch, gastric remnant, or as a component of the anastomoses between hollow viscera. While there are a large number of potential complications from bariatric surgery, one of the most clinically significant complications is leakage of enteric contents along either a marginal staple line or an anastomotic staple line.  Read the rest of this article »

by Jacques Himpens, MD; Giovanni Dapri, MD; and Guy-Bernard Cadière, MD, PhD

Dr. Himpens and Dr. Dapri are from St. Blasius Hospital Dendermonde and St. Pierre Hospital, Brussels, Belgium. Dr. Cadière is from St. Pierre Hospitial, Brussels, Belgium

Introduction
In Europe, sleeve gastrectomy (SG) is swiftly replacing adjustable band gastroplasty (ABG) as the most commonly performed restrictive bariatric procedure. Increasing numbers and longer follow-up times allow us to better evaluate the pros and cons of this relatively new operation. One of the drawbacks of the procedure appears to be the relative frequency and severity of its complications. Reportedly, leaks occur in up to nine percent of the cases, and even more often in revision cases. A majority of leaks appear close to the gastroesophageal junction. These leaks are known to be difficult to treat by conventional means. This retrospective study presents the results of the treatment strategy we offer our patients suffering from leaks at the angle of His after SG. Read the rest of this article »

The Imperial Weight Centre at Charing Cross Hospital, London, United Kingdom

Bariatric Times interviews Ahmed R. Ahmed on his facility being one of the first to achieve Center of Excellence status in the United Kingdom. Read the rest of this article »

Dr. Puhl is the Director of Research & Weight Stigma Initiatives at the Rudd Center for Food Policy & Obesity at Yale University, New Haven, Connecticut.

Introduction
Despite ongoing attention to the obesity epidemic, the social consequences of obesity are often overlooked. In a recent issue of the journal Obesity,[1] a study was published that documents considerable prejudice and discrimination against individuals who are overweight and obese. The study reviews over 150 studies published in the past decade and reveals that weight bias is a persistent social problem affecting obese persons in many settings and often on a daily basis. Speaking with the lead author of the report, Dr. Rebecca Puhl, who is the Director of Research at the Rudd Center for Food Policy and Obesity at Yale University, Bariatric Times addresses this important clinical concern and how it affects the patient. Read the rest of this article »