Biliopancreatic Diversion

Biliopancreatic Diversion is classified as a ‘malabsorptive type’ of morbid obesity surgery.

It is aimed at candidates with:

• Any type of eating habit (consumption of large volume , sweets, or both)
• Metabolic Syndrome
• Body Mass Index (BMI) > 50 (regardless of how high it is, as long as the patient can be anaesthetized, they can undergo the operation – patients have been operated on with Body Mass Index (BMI) > 85)
• A history of gastroesophageal reflux disease
• A previous failed restrictive or mixed type surgery

The selection of the Biliopancreatic Diversion (BPD) is made for each individual, based on an algorithm for each candidate according to their individual history.

The types of Biliopancreatic Diversion (BPD) are as follows:

• BPD – LL – RYGB
• BPD – SADI-S
• BPD – Scopinaro
• BPD – DS

The following videos show in turn the procedures for the above four types of Biliopancreatic Diversion:

Roux-en-Y Gastric Bypass (RYGBP)

Roux-en-Y Gastric bypasses are classified as “mixed type” interventions against morbid obesity.

They are aimed at candidates with:

• Mixed eating habits (consumption of volume and sweets)
• Metabolic Syndrome
• Body Mass Index (BMI) < 50
• A history of gastroesophageal reflux disease
• Low basal metabolism (BMR)
• A previous failed restrictive type surgery

The choice of the type of gastric bypass is made for each individual, based on an algorithm for each candidate depending on their individual history.

The types of RYGBP Gastric Bypass are as follows:

• S – RYGBP
• RYGBP – LL
• RYGBP – LBL
• D – RYGBP

The following video reflects all of the above types:

Gastric Bypass Single Anastomosis MGB / OAGB / SAGI – Types

It is called Laparoscopic Mini Gastric Bypass Single Anastomosis or Laparoscopic Gastric Bypass Single Anastomosis (MGB or OAGB).

Gastric Bypass Single Anastomosis (MGB or OAGB) is classified as a “mixed type” of morbid obesity surgery.

It is aimed at candidates with:

• Mixed eating habits (consumption of volume and sweets
• Metabolic Syndrome
• Body Mass Index (BMI) < 55
• A previous failed restrictive surgery without a history of gastroesophageal reflux disease.

It is more active than the typical gastric bypass, due to the possibility of modifying the degree of malabsorption depending on the case.

The choice of the type of gastric bypass is made for each individual, based on an algorithm for each candidate depending on their individual history.

The types of Gastric Bypass Single Anastomosis are:

• MGB
• OAGB
• Tailoring – OAGB
• SAGI

The following video reflects all of the above types of procedure:

Longitudinal Gastrectomy

Longitudinal gastrectomy (Sleeve Gastrectomy – SG) is classified as a “restrictive type” surgery against morbid obesity.

It is aimed at candidates with:

• Specific eating habits (strictly consumption of large volumes of food – NO sweets)
• Body Mass Index (BMI) < 50
• Increased basal metabolic rate (BMR)(This does not cure metabolic syndrome, but simply improves it)

The choice of longitudinal gastrectomy is made individually, based on an algorithm for each candidate according to their individual history.

The operation is performed both with the classic laparoscopic method, simple or 3D, and with the SILS method (Laparoscopic Surgery by Single Incision) (referral to SILS), as well as robotically (referral to Robotic).

Other Procedures / Obesity Procedures

• Adjustable Gastric Belt or Gastric Band
• Intragastric Balloon
• Gastric Plication 3-layer