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Quality of life after bariatric surgery
One Day Surgery

Bariatric surgery with discharge in 24 to 48 hours. Obesity has a definitive treatment.

Laparoscopic bariatric surgery with ERAS protocol. Dr. Kaiser Jr. combines over 30 years of surgical experience, international training, and advanced rapid recovery protocols to deliver the best outcome with the least possible impact on your life.

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✦ 30+ years of experience ✦ Albert Einstein ✦ 100% laparoscopic
30+
years of surgical experience
24-48h
hospital discharge (ERAS)
100%
laparoscopic
60-80%
excess weight loss
0 years of surgical experience
24-48h hospital discharge (ERAS)
100% laparoscopic
Albert Einstein top-tier hospitals
Bariatric and Metabolic Surgery

More than weight loss: the surgery that treats the disease.

Bariatric and metabolic surgery is a procedure that modifies the digestive system to promote sustainable weight loss and, most importantly, treat diseases associated with obesity — such as type 2 diabetes, hypertension, sleep apnea, and high cholesterol.

This is not an aesthetic choice. Obesity is a chronic, progressive, and multifactorial disease, recognized by the World Health Organization. When diets, exercise, and medications are not enough to control weight and comorbidities, surgery is the treatment with the best long-term results documented by science.

The evidence is robust: studies with over 20 years of follow-up show that bariatric surgery reduces overall mortality by 29%, achieves type 2 diabetes remission in up to 80% of cases, and significantly improves quality of life.

Who qualifies

International guidelines were updated in 2022 (ASMBS/IFSO), expanding access to bariatric surgery for more patients.

BMI ≥ 40
Surgery recommended — regardless of comorbidities
BMI ≥ 35
Surgery recommended — with or without comorbidities (2022 update)
BMI 30-34.9
Surgery may be indicated — in the presence of metabolic diseases or failure of medical treatment

Comorbidities that reinforce the indication

  • Type 2 diabetes mellitus
  • Systemic arterial hypertension
  • Obstructive sleep apnea
  • Dyslipidemia (elevated cholesterol and triglycerides)
  • Non-alcoholic steatohepatitis (fatty liver)
  • Polycystic ovary syndrome (PCOS)
  • Osteoarthritis (joint degeneration)
  • Pseudotumor cerebri
Interactive Tool

Calculate your BMI

Body Mass Index (BMI) is the first criterion for evaluating the indication for bariatric surgery. Find out yours.

27.7
Overweight
18.525303540
Surgical Techniques

Learn about each technique. Understand which is right for you.

Most performed worldwide

Sleeve Gastrectomy

Vertical Gastrectomy

Removal of approximately 75-80% of the stomach, transforming it into a thin tube. In addition to restriction, it causes profound hormonal changes that reduce appetite and improve insulin sensitivity.

60-90 min duration
82%
excess loss (1 year)
75%
diabetes remission
< 0.1% mortality

Advantages

  • Simpler surgery (no intestinal rearrangement)
  • Shorter operative time
  • No risk of dumping syndrome
  • Less supplementation required
  • Can be converted to bypass if needed

Limitations

  • Irreversible
  • May worsen gastroesophageal reflux in 15-20% of cases
  • Greater weight regain long-term compared to bypass
Historical gold standard

Roux-en-Y Gastric Bypass

RYGB

Creates a small gastric pouch (15-30 ml) and redirects the small intestine. The main mechanism is hormonal: dramatic elevation of GLP-1 and PYY, resulting in intense satiety and profound metabolic improvement.

90-150 min duration
70-75%
excess loss (1 year)
74%
diabetes remission
~0.2% mortality

Advantages

  • Strongest long-term scientific evidence (20+ years)
  • Superior for sustained weight loss
  • Better type 2 diabetes remission rates
  • Treats gastroesophageal reflux
  • Durable results for 15-20 years

Limitations

  • More complex surgery (two anastomoses)
  • Risk of internal hernia (1-5%)
  • Dumping syndrome
  • More intensive and mandatory vitamin supplementation
Rising technique

Mini Gastric Bypass

OAGB — One Anastomosis Gastric Bypass

Creates a long tubular gastric pouch and connects it to the small intestine with a single anastomosis. Recognized by IFSO and ASMBS as an approved procedure.

~85 min duration
Superior excess loss vs bypass
84%
diabetes remission
1 anastomosis (vs. 2 in RYGB)

Advantages

  • Faster and technically simpler than RYGB
  • Lower risk of internal hernia
  • Excellent option as revisional surgery after sleeve
  • Metabolic results comparable or superior to RYGB

Limitations

  • Risk of bile reflux (~16%)
  • Less long-term data than RYGB
For those who already had surgery

Revisional Surgery

Conversions and reoperations

When the first bariatric surgery did not achieve the expected result — insufficient weight loss, significant regain, or complications like reflux after sleeve — revisional surgery may be indicated.

Most common conversions

  • Sleeve → Bypass (RYGB): Resolves weight regain and reflux
  • Sleeve → Mini Bypass (OAGB): Shorter surgical time, comparable results
  • Sleeve → SADI-S: For very high BMI or intense metabolic load
  • Band → Sleeve or Bypass: Removal and simultaneous or staged conversion

Revisional surgery has a slightly higher risk than primary surgery, but mortality remains comparable. Dr. Kaiser Jr. carefully evaluates each case.

For complex cases

Duodenal Switch / SADI-S

Greatest metabolic potency

Surgeries with the greatest metabolic potency, typically reserved for patients with BMI > 50 (super obesity) or with very intense metabolic load. Combine sleeve with extensive intestinal redirection.

80-85%
excess loss (BPD-DS)
75-82%
excess loss (SADI-S)
85-100%
diabetes remission
Comparison

The most searched question: Sleeve or Bypass?

Factor Sleeve Bypass (RYGB)
Surgical time 60-90 min 90-180 min
Hospital stay (ERAS) 1 day 2-3 days
Stomach 75-80% removed 15-30 ml pouch
Intestinal rearrangement No Yes
Weight loss (1 year) ~82% EWL ~70-75% EWL
Weight loss (5 years) ~60% EWL ~65-70% EWL
Diabetes remission ~75% ~74-90%
Reflux (GERD) Worsens in 15-20% Improves
Complexity Moderate High
Reversible No Technically possible
Supplementation Moderate Intensive (lifelong)
Weight regain More common after year 2-5 More stable long-term

There is no single "best" surgery for everyone. The choice depends on your BMI, comorbidities (especially diabetes and reflux), expectations, and metabolic profile. Dr. Kaiser Jr. evaluates each case individually to recommend the most appropriate technique.

ERAS Protocol

Discharge in 24 to 48 hours: how the ERAS protocol transformed bariatric surgery.

Dr. Kaiser Jr.'s One Day Surgery concept also applies to bariatric surgery, thanks to ERAS (Enhanced Recovery After Surgery) protocols — a set of evidence-based practices that accelerate recovery and reduce hospital stay with complete safety.

Before

Before surgery

  • Detailed patient education about what to expect
  • Carbohydrate loading the night before (no prolonged fasting)
  • Reduced fasting: 2 hours for clear liquids, 6 hours for solids
During

During surgery

  • Total intravenous anesthesia (TIVA) — faster recovery
  • Multimodal analgesia — opioid minimization
  • Individualized intravenous hydration
  • No nasogastric tube
  • No routine drains
After

After surgery

  • Early ambulation (same day)
  • Oral liquids started in 2-4 hours
  • Pain control with oral medications
  • Antithrombotic prophylaxis

Who can have early discharge

ASA I-II (no severe cardiopulmonary comorbidities)
Tolerating oral intake
Pain controlled with oral analgesics
No intraoperative complications
Good home support
Access to follow-up in 24-72 hours

A systematic review of 6 randomized clinical trials demonstrated that the ERAS protocol reduces hospital stay by 0.42 days without increasing complications or readmissions. For Sleeve, the same-day discharge success rate is 94.6% in high-volume centers.

Scientific Evidence

The 5 numbers you need to know.

0.1%
Operative mortality (comparable to gallbladder surgery)
60-85%
Excess weight loss in 1-2 years
80%
Type 2 diabetes remission rate
29%
Reduction in overall mortality at 10+ years
24-48h
Hospital stay with ERAS / One Day Surgery protocol

Results by comorbidity

Comorbidity Result
Type 2 diabetes Remission in up to 80% — Improvement in 90%
Arterial hypertension Resolution or improvement in ~70%
Elevated cholesterol Resolution in ~80%
Sleep apnea Resolution in ~85%
Hepatic steatosis Significant improvement in most cases
Quality of life Improvement from 48 to 80 points (SF-36 scale) in the first year
FAQ

The answers you need before deciding.

Still have questions? Talk to our team — we respond within 24 hours.

Talk to the team
Am I a candidate for bariatric surgery?

If your BMI is ≥ 35 (with or without comorbidities) or between 30-34.9 with metabolic diseases such as type 2 diabetes, you may be a candidate. The first step is a consultation for individualized evaluation.

What is the difference between Sleeve and Bypass?

Sleeve removes ~80% of the stomach without altering the intestine. Bypass creates a small gastric pouch and redirects intestinal transit. Bypass has better results for diabetes and reflux but is more complex. Sleeve is simpler and has excellent results in 1-2 years. The choice depends on your case.

Is the surgery dangerous?

Mortality is 0.1-0.3% — comparable to gallbladder surgery. In high-volume centers such as the hospitals where Dr. Kaiser operates, the risks are even lower.

How much weight will I lose?

On average, 60-85% of excess weight in 1-2 years. This varies according to the technique, diet adherence, and physical activity. A patient with BMI 45 can expect to reach a BMI close to 27-30.

Can the surgery be done laparoscopically?

Yes. All bariatric surgeries performed by Dr. Kaiser are done laparoscopically — 4 to 6 small incisions. This reduces pain, accelerates recovery, and decreases infection risk.

How long is the hospital stay?

With the ERAS protocol (One Day Surgery): Sleeve in 24 hours, Bypass in 24-48 hours. Discharge depends on oral tolerance, pain control, and absence of complications.

Will I need to take vitamins forever?

Yes. Vitamin supplementation is mandatory and lifelong. Without it, severe deficiencies (anemia, osteoporosis, neuropathy) can develop. Lab tests are performed every 3-6 months in the first year and annually thereafter.

Can I gain weight back after surgery?

There is a risk of weight regain, especially after the 2nd year. Surgery is a powerful tool, but not magic — it requires permanent adherence to diet, exercise, and follow-up. Partial regain (10-15% of lost weight) is common and expected; significant regain may indicate the need for revisional surgery.

Can I get pregnant after bariatric surgery?

Yes, but it is recommended to wait 12-18 months after surgery to stabilize weight and nutritional levels. Nutritional follow-up during pregnancy is essential.

What about the excess skin after weight loss?

Plastic surgery (abdominoplasty, brachioplasty, etc.) can be performed after weight stabilization, usually 12-18 months after bariatric surgery. The amount of excess skin varies according to weight loss and individual skin elasticity.

The Next Step

The first step is simpler than you think.

If you live with obesity and feel like you have tried everything, know that there is a path with science, safety, and follow-up. Talk to Dr. Kaiser Jr.'s team — no commitment.

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