Computational tools for the reliability assessment and the engineering design of procedures and devices in bariatric surgery

Bariatric surgery is the most effective intervention for severe obesity, as one of the most serious health problem worldwide. Laparoscopic adjustable gastric banding is one of the principal technique. Nonetheless, side effects are frequent and weight-loss is not always successful. Non-optimal intervention design, surgery invasiveness and general anesthesia are the principal cause of this situation. A more advanced approach is required, integrating bioengineering and medical competences, aiming to engineering design the procedure, to improve efficacy and to reduce the need for anesthesia. Computational methods can be exploited to evaluate stomach functionality after surgery and to interpret mechano-biological processes, aiming at the optimal design of the intervention. Results from coupled experimental and computational activities are here reported, showing the potentialities of the engineering approach. Endoscopic surgery should minimize invasiveness and anesthetic requirement, but previously proposed techniques demonstrate marginal efficacy. Procedural consistent advances are required, as devices designed to provide endoscopic gastric banding. Preliminary results from computational activities are proposed, again to show the capabilities of the engineering approach to mimic and to optimize the overall surgical procedure.