Hospital Universitario La Moraleja Madrid


Bariatric (Morbid Obesity) Surgery Unit

Bariatric surgery is the name given to the series of surgical procedures that can be used in the treatment of morbid obesity (BMI>35). This type of surgery is used when treatments based on nutritional diets have not worked previously. The surgery reduces appetite, generally shrinking the stomach and therefore reducing the amount of food ingested.

However, bariatric surgery must always be complemented with a diet and with education of the patient which leads them to alter their lifestyle, both with regard to diet and in terms of exercise.



Interventions whose sole objective is the ion of fat, such as liposuction and abdominoplasty, are not d in bariatric surgery. There are different types of surgical procedures:

  • Gastric bypass: the most common procedure. This procedure reduces the capacity of the stomach to 20-50 cc (this reduces the amount of food that can be ingested), and it is connected to a more advanced stretch of the small intestine (bypass) such that 60% of it is used for the absorption of food. The amount of weight lost will depend on the behaviour of the patient after the intervention, with regard to their strictness in following the diet imposed by the doctor and the quality and quantity of the physical exercise they perform. In one year up to 50-70% of the excess weight can be lost.
  • Adjustable gastric band: consists of the fitting of an adjustable ring around the entry of the stomach, the regulation of which determines the capacity of the stomach and, therefore, the amount of food that can be ingested.
  • Vertical sleeve gastrectomy: the weight loss is achieved by reducing the volume of the stomach by approximately 80%.
  • Endoscopic sleeve gastroplasty: the stomach is folded in on itself, thus reducing its capacity.
  • Duodenal switch: similar to the gastric bypass except that in this case the bypass towards the small intestine is ed at the duodenum, such that 50% is used for the absorption of food.
  • Biliopancreatic diversion.

To undergo any of the bariatric surgery procedures described, a multidisciplinary team is d and the patient must be subject to an integral assessment beforehand, including a psychological assessment, as these techniques are contraindicated for under 13s and over 65s, and in people with mental illnesses preventing their cooperation in the follow-up of the treatment after surgery.



In addition to the risks of any complex surgical procedure, in bariatric surgery, complications can arise, affecting some 10% of patients:

  • Persistent vomiting (caused by excess eating).
  • Difficulty swallowing.
  • Rupture of the staple line (and possible leakage of gastric acids).
  • Opening of the surgical wound
  • Ulcers.
  • Gastric pouch distension.
  • Nutritional deficiencies that may cause anaemia or osteoporosis.



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