Current trends in bariatric surgery

Bariatric surgery remains the most effective method of treating morbid obesity, however, modern approaches require the integration of pharmacotherapy and multidisciplinary support to achieve sustainable results. The purpose of this literature review was to analyze current trends in bariatric surgery, evaluate the effectiveness of various surgical interventions, as well as the role of pharmacotherapy and standardization of protocols in improving the quality of treatment. A review of randomized clinical trials, meta-analyses, and registry data on the outcomes of laparoscopic longitudinal gastric resection (PRG), the use of GLP-1 agonists and double GIP/GLP-1 agonists, multidisciplinary patient management, and the implementation of ERAS protocols has been performed. Longitudinal gastric resection provides 60–70 % of excess body weight loss (EWL) within 5–7 years and remission of type 2 diabetes in 50–60 % of cases, comparable with the results of gastric bypass surgery. For patients with superobesity, this technique remains highly effective and safe. A multidisciplinary approach helps to reduce the risk of relapse and increase the effectiveness of therapy. Pharmacotherapy using semaglutide and tirzepatide is effective both before and after surgery, reducing the frequency of weight loss. The standardization of treatment protocols has reduced the incidence of complications to 1.06 % and shortened the duration of hospitalization. Laparoscopic longitudinal gastric resection remains the basic method of bariatric surgery, the effectiveness of which is significantly increased when combined with pharmacotherapy and comprehensive multidisciplinary management. The use of digital technologies and the standardization of treatment protocols contribute to increased safety and improved longterm treatment outcomes for patients with morbid obesity.