Sleeve gastrectomy and active intestinal bypass in patients with severe obesity

INTRODUCTION: Bariatric surgery is the most effective treatment modality for severe obesity in adults and children. Numerous recent investigations by foreign authors have convincingly proven the successful and safe implementation of a variety of bariatric and metabolic surgical methods for definite and stable weight reduction.AIM: The aim of the present article is to concisely review the most recent publications in the field of bariatric surgery in patients with morbid obesity and to share our initial experience by three case reports.MATERIALS AND METHODS: We briefly report three patients with severe obesity, two women and one man, who were operated on by sleeve gastrectomy and active intestinal bypass in the Clinic of Surgery at the Naval Hospital in Varna, part of the Military Medical Academy, in the 2020–2022 period. They were followed up until 2024.RESULTS: This surgical intervention resulted in a remarkable weight loss and a body mass index reduction. The male patient’s weight decreased from 220 kg down to 82 kg. The female patients’ weight reduction was from 198 kg down to 83 kg and from 127 kg down to 76 kg, respectively.CONCLUSION: There is accumulated evidence on the sufficient safety and significant effectiveness of the bariatric surgery in selected patients with severe obesity. A broader implementation of this modern method in the clinical practice in Bulgaria should be recommended.