Most important procedures

There are several procedures that have been developed for more than 30 years. Some are much more frequently performed according to certain countries, or different habits from physicians and surgeons. Trends are coming up, sometimes with discrepancies. In the United States, complex procedures are currently ahead, while in Europe laparoscopic procedures using adjustable bands are leading for a few years.

At a first look, we can distinguish two types of procedures:
restrictive and malabsorbtive operations. The first ones aim to restrict the capacity of the stomach, thus creating satiety in a simple way. But they elicit discomfort and vomiting at first. Then over the time patients will cope with it and therefore results are less interesting in the long run. That is the reason why in the US, where the population of obese people having poor food-habits is very large, more aggressive procedures are done, using malabsorbtion, i.e. a decreased absorption of food by the alimentory tract. Different procedures are used, mainly employing a bypass between the stomach and the small bowel. These techniques are more complex than the restrictive ones, and the consequences are more serious, demanding a careful attention in the follow-up. But long-term effectiveness is obviously better in terms of weight-control. Our purpose is to describe herewith only the three major procedures : the adjustable band, the gastric stapling and the gastric-bypass.