[Current status of obesity surgery as metabolic surgery]

Obesity Surgery is not only capable to reduce body weight of the morbid obesity patients but also capable to treat complications such as Diabetes, Hypertension, Hyperlipemia and etc. From this point view, obesity surgery is recently called Metabolic Surgery, intending to treat Metabolic Syndrome. Gastric Bypass, Adjustable Gastric Banding, Vertical Banded Gastroplasty, and Biliopancreatic Diversion are widely recommended in the world. We have operated 97 cases of morbid obesity patients with various types of gastric bypass and gastroplasty since 1982. Laparoscopic surgery is induced in the field of obesity surgery around 1995, and since then, it has been exploring rapidly over the world. Two thirds of total cases are recently operated laparoscopicaly in the world. We adopted laparoscopic obesity surgery in 2000, and now several institutions are operating with laparoscopy even in Japan. Considering the characteristic features of Japanese obese, we should have our own guideline for obesity surgery. Patients who have BMI > or =35 and severe complications which need to be treated promptly should be applied to surgical treatment in Japan.