The number of bariatric procedures has grown exponentially over the past few years. In the year 2000, 40,000 procedures were performed; 80,000 were performed in 2002; 100,000 procedures were performed in 2003;1 and it is estimated that 140,000 bariatric procedures were performed in 2004.2 Bariatric surgery, including Roux-en-Y gastric bypass, gastric restrictive procedures, laparoscopic adjustable gastric banding, and bilio-pancreatic diversion, provides effective weight loss with the added benefit of the majority of patients achieving improvement or complete resolution of hypertension, Clinical Insights in Bariatric Surgery Volume 1, Number 1 January/February 2005 Presents Management of Tissue Attachment Through the Use of SurgiWrap® Bioresorbable Sheets A fibrin matrix forms between adjacent tissues following abdominal procedures causing tissue attachment. by Noel N. Williams, MD, MCh, FRCSI, FRCS (Gen) Dr. Williams is the Director of the Bariatric Program, Department of Surgery, at the University of Pennsylvania in Philadelphia, Pennsylvania. hyperlipidemia, obstructive sleep apnea, and diabetes.3 The mortality rates range between 0.1 and 0.5 percent for the more popular procedures, showing that bariatic surgery is not only effective, but safe.3 As with any abdominal surgery, however, a problem often encountered following weight loss surgical procedures is the formation of dense fibrous tissues. What are tissue attachments? Why do they form? How can they be managed? This article will answer these important questions.