Original article
Laparoscopy in bariatric surgery in Poland – present status

Background: Obesity causes other pathologies which could be life-threatening. Morbid obesity affects about 300 000 patients in Poland. Because conservative treatment of morbid obesity is ineffective, it should be treated by bariatric surgeons. All bariatric procedures could be performed via a laparoscopic approach nowadays.
Materials and methods: The number and type of bariatric procedures performed between January 1993 and June 2006 has been based on data collected from Polish surgeons active in this field.
Results: In the above period 2584 primary bariatric procedures were performed in total. Among these 77% were restrictive, including: vertical banded gastroplasty (VBG) (64.3%), adjustable gastric banding (AGB) (37.1%), and sleeve gastrectomy (SG) (0.2%). Less popular are malabsorptive procedures (23%), with Roux-en-Y gastric bypass (RYGB) (86.5%) and biliopancreatic diversion (BPD) (13.5%). During the year 2005 restrictive operations represented 78.5% of all primary procedures, and the most popular was AGB (69.5%). RYGB represented 93.6% of primary malabsorptive procedures performed in 2005. Laparoscopic technique was used for the first time in AGB in 1998, in RYGB in 2000, in VBG in 2004 and in BPD and SG in 2005. More than 60% of primary bariatric procedures are done by laparoscopy approach nowadays. All AGB procedures (except conversions), half of VBG and one third of RYGB were done by laparoscopy during the analyzed period of 2006.
Conclusions: Most primary bariatric procedures are performed by laparoscopy technique nowadays in Poland. Although the number of morbidly obese patients treated surgically in Poland is increasing, it is still inadequate to meet the growing demand.