Minimally invasive management of obesity: Pearls, pitfalls and experience in the Caribbean

Abstract

Abstract Obesity is an epidemic with a worldwide distribution, which affects all ages. This lifestyle disease co-exists with other conditions such as diabetes, hypertension, hypercholesterolemia and obstructive sleep apnoea. The surgical management of obesity has gone through several significant modifications and it is well accepted as a viable modality of treatment. The approach to the obese patient is multifaceted and as such a multidisciplinary approach is advocated. In the first world setting the holistic method is commonplace and easily facilitated, as these procedures are performed in high volume centres. In the Caribbean, there are many factors which have impeded the concept of surgical management of obesity. These include cultural attitudes toward obesity, economics, health care priorities in developing countries and patient compliance. Additionally, there is a lack of adjunct facilities which aid in the early detection and management of complications encountered after metabolic surgery. Despite these challenges there has been several publications documenting acceptable outcomes. The development of a Centre of Excellence for Bariatric Surgery is accompanied by numerous benefits and has the potential of overcoming obstacles encountered in the past.