10
Metabolic and Bariatric Surgery
Bariatric Surgery Procedures
Procedure Advantages Considerations/Risks
Roux-en-Y
Gastric Bypass
Strong metabolic
effect compared
with sleeve; helps
gastroesophageal
reflux; restrictive plus
mild malabsorption
Higher risk of
malabsorption-related
issues than sleeve
(but lower than
duodenal switch)
Vertical Sleeve
Gastrectomy
(VSG/SG)
Improves metabolic
health; keeps intestinal
continuity; simpler
anatomy
Can cause or worsen
GERD; potential need
for conversion to bypass
or medical therapy; not
reversible
Laparoscopic
Adjustable
Gastric Banding
(LAGB)
Device is removable Less durable weight loss;
declining use; device-
related issues and need
for adjustments
Biliopancreatic
Diversion with
Duodenal Switch
Greatest average
weight loss and
strongest metabolic
impact
Highest risk of
macro-/micronutrient
deficiencies; technically
complex
Single
Anastomosis
Duodeno-Ileal
Bypass
Similar efficacy to
BPD/DS with a simpler
configuration
Nutrient deficiencies
can occur; not reversible
