[Surgery for obesity].

Abstract

With the development of new surgical techniques (laparoscopic procedure, adjustable gastric banding) bariatric surgery is still increasing. In France about 10,000 adjustable gastric banding have been performed during the last year, as well as a thousand of gastric operations and approximately fifty gastric by-pass. The surgical approach has a real efficacy on weight loss and is associated with a reduction in comorbid conditions. However its long-term efficacy, its effects on quality of life, its nutritional consequences and the surgical-linked complication incidence are only poorly evaluated, especially for adjustable gastric banding. Therefore bariatric surgery indications should be thoroughly examined. As recommended by the experts, surgical treatment for obesity should be restricted to patients presenting morbid obesity, and this despite a multidisciplinary medical treatment. Long-term post-surgical follow-up is necessary and may be an important determinant of long-term efficacy. Considering the growing number of this type of intervention outside of any evaluation, a national register is recommended.