[Special considerations in bariatric surgery]

Bariatric surgery is proven to be the most effective treatment for obesity and its associated metabolic diseases. In this review article, we aim to present the current developments and specific aspects of metabolic surgery, based on the scientific literature and the current trends of some high-volume bariatric centers. In North America – as well as in Europe and Hungary –, the most common bariatric procedures are the laparoscopic Roux-en-Y gastric bypass and the sleeve gastrectomy. A relatively new malabsorptive procedure, the single anastomosis duodenal-ileal bypass, is also being performed with increasing frequency. This article provides an overview of the long-term outcomes of these surgeries in terms of weight loss and their impact on comorbidities, based on relevant scientific literature from recent years. We also discuss the main factors influencing the choice of surgical technique, such as gastroesophageal reflux disease, hiatal hernia, preoperative body mass index, and the severity of associated diseases. Revision options are also addressed. Given the essential role of a multidisciplinary approach in modern bariatric surgery, we briefly touch on endobariatric procedures as well. Considering the severity of obesity in Hungary and the increasing number of bariatric procedures in the country, we believe our article may be of interest to the Hungarian medical community. Orv Hetil. 2025; 166(32): 1243–1249.