Authors' objectives:

This report aims to assess the benefit-risk ratio of the principle surgical procedures for morbid obesity in adults.

Authors' recommendations: Obesity is an increasingly important public health problem which ususally requires multidisciplinary management for prevention and treatment. Indications, conditions for performance of surgery and type of surgery for obesity are clearly defined in existing guidelines. The increased prevalence of obesity and the use of new techniques (laparoscopic approach, insertions of gastroplasty rings) have resulted in a large increase in the number of surgical procedures performed. When patients have ben properly selected, the benefit-risk ratio for vertical banded gastroplasty and gastric bypass is acceptable. This also applies for gastroplasty rings with regard to short-term evaluation of the procedure. The following points need to be emphasised: - The gastroplsty ring technique is the simplest, which gives it advantages in relation to the surgery itself. It also has the advantages of being closer to the normal physiological situation and of being reversible. However, it seems to be slightly less effective in terms of weight loss than vertical banded gastroplasty and gastric bypass. In addition, lack of follow-up means that its long-term benefits have not yet been evaluated. - All three techniques may involve complications common to any type of surgery, together with complications specific to the procedure. These are rarely severe but often require revision surgery. In view of the inadequate long-term evaluation of either efficacy or inherent risk of gastroplasty rings (notably risks relating to how the prosthetic material is tolerated, and risk of migration of the ring into the stomach), the working group was concerned about the extensive and unevaluated diffusion of this technique which is currently taking place.

Authors' methods: Review

Project Status: Completed

URL for project: http://www.has-sante.fr

Year Published: 2001

English language abstract: An English language summary is available

Publication Type: Not Assigned

Country: France

Organisation Name: L'Agence Nationale d'Accreditation d'Evaluation en Santé

Contact Address: 2 avenue du Stade de France, 93218 Saint-Denis La Plaine Cedex, France. Tel: +33 01 55 93 71 88; Fax: +33 01 55 93 74 35;

Contact Name: sh.leerobin@has-sante.fr

Contact Email: sh.leerobin@has-sante.fr

Copyright: L'Agence Nationale d'Accreditation d'Evaluation en Sante (ANAES)