La chirurgia bariatrica comprende una varietà di procedure volte al trattamento dell’obesità grave e delle sue comorbidità. Negli ultimi anni, oltre agli interventi tradizionali, sono emerse nuove tecniche meno invasive, come l’endosleeve (endoscopic sleeve gastroplasty), il Bariclip (laparoscopic vertical clip gastroplasty) che offrono alternative promettenti per pazienti selezionati.
Di seguito è riportata una tabella aggiornata al 2025 che include questi interventi, specificando il loro attuale utilizzo, il meccanismo d’azione e le relative fonti bibliografiche.
Tabella: Principali Interventi di Chirurgia Bariatrica
| Intervento | Attuale Utilizzo | Meccanismo | Riferimenti Bibliografici |
| Bypass Gastrico Roux-en-Y (RYGB) | Ampiamente utilizzato | Misto | [1,2,3] |
| Gastrectomia a Manica (Sleeve Gastrectomy) | Ampiamente utilizzato | Restrittivo | [2,4] |
| Bendaggio Gastrico Regolabile (LAGB) | In declino | Restrittivo | [5,6] |
| Diversione Biliopancreatica con Duodenal Switch (BPD/DS) | Raramente utilizzato | Misto | [3,7] |
| Bypass Gastrico a Singola Anastomosi (OAGB) | In crescita | Misto | [8] |
| Bypass Digiuno-Ileale (JIB) | Abbandonato | Malassorbitivo | [9] |
| Gastroplastica Verticale Banderata (VBG) | Abbandonato | Restrittivo | [10] |
| Endosleeve (Endoscopic Sleeve Gastroplasty) | In crescita | Restrittivo | [11,12,13] |
| Bariclip (Laparoscopic Vertical Clip Gastroplasty) | Sperimentale | Restrittivo | [14,15,16] |
| SADI-S (Single Anastomosis Duodeno-Ileal Bypass con Sleeve Gastrectomy) | In crescita | Misto | [17,18,19] |
La tabella può essere copiata o modificata per tutti gli usi solo con citazione della fonte.
Fonte: Ivan Zucconelli. Gli interventi di chirurgia bariatrica. 2025. www.ivanzucconelli.it
Bibliografia:
- Schauer PR, Ikramuddin S, Gourash W, Ramanathan R, Luketich J. Outcomes after laparoscopic Roux-en-Y gastric bypass for morbid obesity. Ann Surg. 2000;232(4):515-529.
- Angrisani L, Santonicola A, Iovino P, et al. Bariatric Surgery Worldwide 2013. Obes Surg. 2015;25(10):1822-1832.
- Buchwald H, Avidor Y, Braunwald E, et al. Bariatric surgery: a systematic review and meta-analysis. JAMA. 2004;292(14):1724-1737.
- Gagner M, Deitel M, Kalberer TL, Erickson AL, Crosby RD. The Second International Consensus Summit for Sleeve Gastrectomy, March 19-21, 2009. Surg Obes Relat Dis. 2009;5(4):476-485.
- O’Brien PE, Dixon JB, Laurie C, et al. Treatment of mild to moderate obesity with laparoscopic adjustable gastric banding or an intensive medical program: a randomized trial. Ann Intern Med. 2006;144(9):625-633.
- Eid GM, McCloskey C, Eagleton JK, et al. Staged laparoscopic Roux-en-Y gastric bypass as a safe and effective alternative for the super-super obese patient. Obes Surg. 2005;15(4):530-534.
- Marceau P, Hould FS, Béchard P, et al. Biliopancreatic diversion with duodenal switch. World J Surg. 1998;22(9):947-954.
- Rutledge R, Walsh TR. Continued excellent results with the mini-gastric bypass: six-year study in 2,410 patients. Obes Surg. 2005;15(9):1304-1308.
- Payne JH, DeWind LT. Surgical treatment of obesity. Am J Surg. 1969;118(2):141-147.
- Mason EE, Printen KJ. Gastric bypass in obesity. Surg Clin North Am. 1979;59(6):1345-1351.
- Alexandre F, Lapergola A, Vannucci M, et al. Endoscopic management of obesity: Impact of endoscopic sleeve gastroplasty on weight loss and co-morbidities at six months and one year. J Visc Surg. 2023;160(2S):S38-S46.
- Polese L, Prevedello L, Belluzzi A, et al. Endoscopic sleeve gastroplasty: results from a single surgical bariatric centre. Updates Surg. 2022;74(6):1971–1975.
- Nduma B, et al. Endoscopic Gastric Sleeve: A Review of Literature. Cureus. 2023;15(4):e37082499.
- Bonaldi M, Uccelli M, Lee YH, et al. BariClip: Outcomes and Complications from a Single-Center Experience. Obes Surg. 2024;34(11):4220-4227.
- Gentileschi P, Campanelli M, Sensi B, et al. Safety and Efficacy of Laparoscopic Vertical Clip Gastroplasty: Early Results of an Italian Multicenter Study. Obes Surg. 2023;33(1):303-312.
- Noel P, Nedelcu M, Olmi S, et al. Evolving Technique of Laparoscopic Vertical Gastric Clip Placement. Obes Surg. 2023;33(4):1012-1016.
- Ponce de Leon-Ballesteros G, Romero-Velez G, Higa K, et al. The Efficacy and Safety of Laparoscopic Single-Anastomosis Duodeno-ileostomy with Sleeve Gastrectomy (SADI-S) in Mid- and Long-Term Follow-Up: a Systematic Review. Obes Surg. 2024;34(10):3639-3685.PMC+10PubMed+10SpringerLink+10
- Balamurugan G, Leo SJ, Sivagnanam ST, et al. Comparison of Efficacy and Safety Between Roux-en-Y Gastric Bypass (RYGB) vs One Anastomosis Gastric Bypass (OAGB) vs Single Anastomosis Duodeno-ileal Bypass with Sleeve Gastrectomy (SADI-S): a Systematic Review of Bariatric and Metabolic Surgery. Obes Surg. 2023;33(7):2194-2209.PubMed
- Sánchez-Pernaute A, Rubio MA, Pérez-Aguirre E, et al. Long-Term Results of Single-Anastomosis Duodeno-ileal Bypass with Sleeve Gastrectomy (SADI-S). Obes Surg. 2022;32(2):405-414.PMC
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