Evolution and comparison of the main bariatric surgery techniques: gastric bypass, vertical gastrectomy (sleeve) and adjustable gastric band

Abstract

Introduction: Bariatric surgery is an effective approach in the treatment of severe obesity, and is indicated when other weight loss strategies, such as dietary changes and physical exercise, fail. Among the main bariatric surgery techniques, the following stand out: Gastric Bypass, Vertical Gastrectomy (Sleeve) and Adjustable Gastric Band. Each of these techniques has specific indications, advantages and disadvantages, which should be considered based on the patient's needs and health conditions. The choice of the appropriate procedure depends on factors such as the degree of obesity, associated comorbidities, medical history and personal preferences of the patients. The evolution of these techniques has provided significant results in terms of weight loss, control of comorbidities and improvement in quality of life. Assessing the differences between these procedures is essential to provide accurate information to patients and promote better long-term results. Objective: The objective of this study is to conduct a literature review on the main bariatric surgery techniques – Gastric Bypass, Vertical Gastrectomy (Sleeve) and Adjustable Gastric Band. The comparative analysis seeks to clarify the indications, results, and complications associated with each technique, in addition to evaluating improvements in patients' quality of life and the clinical benefits of each of these approaches over time. Methodology: To prepare this study, a systematic review of the literature was carried out in order to compare the main bariatric surgery techniques: Gastric Bypass, Vertical Gastrectomy (Sleeve), and Adjustable Gastric Band. The research was conducted using Health Sciences Descriptors (DeCs) to identify relevant articles on the evolution, efficacy, and complications of these approaches. Searches were performed in several scientific databases, including PubMed, Google Scholar, SciELO, Virtual Health Library (BVS), and EbscoHost, focusing on articles published between 2010 and 2023. Conclusion: Bariatric surgery has evolved significantly over the years, with the introduction of less invasive and more effective techniques in controlling obesity and its comorbidities. Gastric Bypass, Sleeve Gastrectomy and Adjustable Gastric Banding present important differences in terms of indications, long-term results and associated complications. Gastric Bypass continues to be considered the most effective procedure in terms of weight loss and control of associated diseases, but Sleeve Gastrectomy has stood out due to its lower complication rate and faster recovery. Adjustable Gastric Banding, although less performed today, is still a viable option for patients with fewer comorbidities. The choice of procedure should be personalized, considering the individual characteristics of each patient, and it is essential that patients are well informed about expectations and postoperative care. Continuing comparative studies and the evolution of these techniques are essential to improve the results and quality of life of bariatric patients.