Obesity Surgery

, Volume 12, Issue 6, pp 733–746 | Cite as

A Bariatric Surgery Algorithm

  • Henry Buchwald

Background: Three premises underlie this formulation of an algorithm: 1) there is no gold standard operation; 2) the bariatric surgeon should be able to perform more than one bariatric operation; and 3) a patient can be broadly matched to an operation. Methods: Literature review and interpretation., Results: The 5 currently clinically-tested bariatric procedures, ranked from least to most weight loss, are: 1) gastric banding (GB); 2) vertical banded gastroplasty (VBG); 3) Roux-en-Y gastric bypass (RYGBP); 4) biliopancreatic diversion (BPD) or duodenal switch (DS); and 5) long-limb Roux-en-Y gastric bypass (LLRYGBP). The following diagram for decision-making takes into consideration body mass index (BMI); age; gender, race, and body habitus (GRH); and comorbidities (CoM): (Diagram not available in this format) This diagram can be converted to an equation; OC =1.0+BMI Number (1 to 6) ±0.5 (age<40>) ±0.5 (GRH, Favorable or Unfavorable) ±1 (CoM, Low or High), where OC=operative category: GB=0 to 3, VBG=2 to 5, RYGBP=3 to 6, BPD/DS=4 to 7, and LLRYGBP=6 to 9. Overlap between OCs integers allows for surgeon and patient preference. Conclusions: A diagram or equation algorithm for operative selection in the morbidly obese has been constructed.


Body Mass Index Bariatric Surgery Gastric Bypass Morbid Obesity Gastric Banding 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


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Copyright information

© Springer 2002

Authors and Affiliations

  • Henry Buchwald

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