Bariatry - surgical therapy of the severe obesity

When conservative therapy of the morbid obesity repeatedly fails bariatric surgery begins. Adults patients from 18 to 60 age with obesity 3rd grade (BMI > 40 kg/m2 ), respectively 2nd grade (BMI > 35 kg/m2 ), with symptomatic diseases caused by obesity as type 2 diabetes, hypertension, dyslipidaemia or heavy failure of the joints, in which conservative therapy failed, are indicate for bariatric surgery. Nearly all of the bariatric procedures are providing by laparoscopy at present. Contemporary bariatric surgery is using restrictive or malabsorptive or combination of both operating methods. Adjustable gastric banding and vertical gastric plication are pure restrictive bariatric method. The most popular restrictive method with partial hormonal effect is sleeve gastrectomy at present. Biliopancreatic diversion is considered to be a pure malabsorptive bariatric method. Majority of the bariatric surgeons consider gastric bypasses as malabsorptive restrictive method.