Currents and Trends in Bariatric Surgery

Abstract

Introduction: Bariatric surgery has been shown to be more effective than medical treatment to control overweight. Many techniques have been described in recent years depending on the mechanism involved. Restrictive, malabsorptive and mixed techniques being the first the most commonly practiced by surgeons. Materials and methods: Review article of the restrictive techniques in bariatric surgery searched the databases PubMed and Cochrane. Results: Gastroplasty: This consisted of creating a gastric pocket vertically, the short-term results were good, with low excess weight over 60% the first year. Adjustable gastric banding: The technique consists of a silicone band fitted with an adjustable ball, which is implanted laparoscopically at the gastroesophageal junction; the low weight is lower and slower when compared to the gastric bypass, but can reduce over 60% of excess weight. Tubular gastrectomy: The surgical technique involves determining a vertical gastrectomy determined by a narrow gastric tube at the expense of the lesser curvature of the stomach and preserving 3 to 4 cm wide, regarding the results in weight loss, a systematic review reported low rates of overweight between 33 and 85%, averaging 55.4%. Gastric plication: Its principle is basically the dissection of the greater curvature and its plication or invagination into the gastric lumen and lesser curvature, where one or more fixed suture lines, leaving a large intraluminal fold, the percentage of excess weight loss is progressive, stabilizing at 1 year of follow-up in about 60% loss of excess weight, keeping this results at 2 and 3 years of follow-up. Discussion: The prevalence of obesity is increasing in the recent decade, and now is one of the leading public health problem on a worldwide scale, bariatric surgery is currently the most efficacious and enduring treatment for clinically severe obesity, certainly the training and the bariatric surgeon’s experience are important factors that must be improved for the benefit of the patient. Conclusion: The restrictive bariatric surgery techniques have evolved over the last time, with the help of technological advances that have made possible, allowing improved results. The choice of technique should be very careful, because all have potential complications and risks.