Primary bariatric surgery – how to make a choice?
https://doi.org/10.17238/2072-3180-2025-20-30
Abstract
Introduction. Given the limited efficacy of conservative treatment methods, bariatric surgery is now considered the most effective approach for achieving sustained weight loss and metabolic improvement in patients with morbid obesity. Currently, there is no clearly defined algorithm for selecting primary bariatric procedures, which significantly complicates decision-making for early-career bariatric surgeons and multidisciplinary teams. Most specialists rely on expert opinions from leading bariatric surgeons and clinical obesity treatment guidelines.
Materials and Methods. We analyzed contemporary approaches to optimal bariatric procedure selection based on clinical guidelines from major international and Russian organizations and current research data.
Results. Based on the comparative benefits, limitations, and patient-specific factors, we developed an algorithm for selecting primary bariatric procedures for patients with obesity and metabolic syndrome.
Conclusion. The proposed algorithm demonstrates that selection of primary bariatric surgery should be based on multiple factors affecting procedural safety and efficacy. Implementation of this algorithm helps standardize surgical decision-making while allowing personalized adaptation of surgical strategy according to individual patient characteristics, thereby reducing complication risks and improving outcomes.
About the Authors
A. E. Neymark
FSBI "NMRC named after V.A. Almazov" of the Ministry of Health of Russia
Russian Federation
Russian Federation
Neymark Alexander Evgenievich – Candidate of Medical Sciences, Associate Professor, Leading Researcher of the Research Institute of Diabetology of the Institute of Endocrinology, Surgeon
197341, Akkuratova str., 2, Saint Petersburg
S. E. Lapshina
FSBI "NMRC named after V.A. Almazov" of the Ministry of Health of Russia
Russian Federation
Russian Federation
Lapshina Sofya Evgenyevna – Surgeon, Assistant at the Department of Faculty Surgery with the Clinic of the Institute of Medical Education
197341, Akkuratova str., 2, Saint Petersburg
B. V. Sigua
FSBI "NMRC named after V.A. Almazov" of the Ministry of Health of Russia
Russian Federation
Russian Federation
Sigua Badri Valerievich – MD, Professor, Head of the Department of General Surgery, Faculty of Medicine, Institute of Medical Education
197341, Akkuratova str., 2, Saint Petersburg
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For citations:
Neymark A.E., Lapshina S.E., Sigua B.V. Primary bariatric surgery – how to make a choice? Moscow Surgical Journal. 2025:20-30. (In Russ.) https://doi.org/10.17238/2072-3180-2025-20-30
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