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The epidemic of obesity has been increasing globally, with major public health and financial implications. Developed countries were initially more affected, but now developing countries are increasingly contributing to the epidemic.
Obesity is associated with increased risk of mortality due to problems related to the metabolic syndrome, as well as increased intra-abdominal pressure (IAP). The metabolic syndrome is associated with insulin resistance and type II Diabetes Mellitus, hyperlipidemia and systemic hypertension. Increased abdominal pressure is associated with obesity hypoventilation, gastroesophageal reflux disease, stress urinary incontinence, pseudotumorcerebri and venous insufficiency. Central obesity is responsible for sleep apnea and degenerative joint disease. In addition to this, cancers of the endometrium, colon, renal cell, breast and prostate are found to be more common in the obese.
Today more laparoscopic bariatric procedures are being performed than open procedures annually, worldwide. By reducing the size of the surgical incision and decreasing the operative trauma from abdominal wall retractors and mechanical retraction of the abdominal viscera, the surgical insult is less after laparoscopy, as compared to open surgery. Decreased post-operative pain, lower rate of wound related complications, reduced incidence of postoperative incisional hernia and faster recovery are the other advantages of the laparoscopic technique.