Surgical therapy to help the severely overweight has been performed for the
past 40 years, As with every therapeutic modality, there have been changes
, refinements and improvement as this therapy has evolved. Although the bas
ic concept of gastric bypass remains intact, numerous variations are being
performed at this time. Recent data compiled by the International Bariatric
Surgery Registry have demonstrated that surgeons are moving from simple ga
stroplasty procedures, favouring the more complex gastric bypass procedures
as the surgical treatment of choice for the morbidly obese patient, This r
eview will discuss the evolution of the gastric bypass procedures, and the
reasons for and results of the changes. Gastric bypass may represent the be
st surgical approach for the treatment of morbid obesity. (C) 1999 Lippinco
tt Williams & Wilkins.