They reduce the volume of intake. The best and most promising currently is LAPAROSCOPIC VERTICAL GASTRECTOMY OR GASTRIC TUBE, which also causes a metabolic effect on the hormones produced by the intestine – incretins, correcting diabetes and improving other comorbidities such as dyslipidemia, hypertension or sleep apnea. Since 2014 it is the most frequently performed technique in the world.Intragastric balloons, LapBand-type rings or POSE, present disparate and variable results, with lower weight losses and less sustained over time, leading to a significant number of failures.More than 80% of patients treated with the intragastric balloon regain their lost weight 6 months after removing it. 25% of patients with a laparoscopic ring or band need to undergo surgery again due to unsatisfactory results. The success rate is small (loss > 50% of excess weight), 55% at 3 years, 45% at 5 years and 35% at 8 years, and the failures are numerous (loss < 25% of Excess Weight), 15% in the first 3 years, 30% at 5 years, and 40% at 8 years, when the number of failures is greater than successes. These results are as discouraging in the medium and long term as those obtained by ring gastroplasties, fashionable in the 90s, and now out of use.
In addition to reducing the volume of intake, they associate controlled malabsorption. The best and most accepted of all bariatric techniques against morbid obesity is the LAPAROSCOPIC GASTRIC BYPASS. It is considered the Gold Standard or Gold Standard Technique against which other techniques are compared. It has been the most performed bariatric and metabolic technique in the world.Other more aggressive techniques such as Duodenal Crossing are indicated in very special cases of extreme obesity, in addition to being used increasingly less frequently.In recent years, new bariatric and metabolic techniques have been developed, such as the SADI-s (variation of the classic Duodenal Crossing but with only one anastomosis), the mini-Gastric Bypass (simplified bypass controversial due to possible risk of biliopancreatic reflux in the gastric remnant). and the esophagus), DUODENO-ILEAL BYPASS with or without Vertical Gastrectomy (promising metabolic technique for Diabetes), etc.
