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signs."},"follow_up_visits":[{"purpose":"wound_check","requirement":"routine","after":{"min":7,"max":21,"unit":"days","qualifier":"First postoperative review, typically 1-3 weeks after surgery."}},{"purpose":"assessment","requirement":"routine","after":{"min":80,"max":100,"unit":"days","qualifier":"Around 3 months: weight, nutrition, diabetes/medication review."}},{"purpose":"result_review","requirement":"routine","after":{"min":170,"max":200,"unit":"days","qualifier":"Around 6 months, then periodic lifelong follow-up."}}],"indications":["BMI ≥35, or ≥30 with comorbidity, after failed non-surgical treatment","Type 2 diabetes with obesity, aimed at improving glycemic control","Obesity-related hypertension, sleep apnea, dyslipidemia, fatty liver"],"main_risks":["Bleeding","Staple-line or anastomotic leak and infection","Venous thromboembolism","Stricture or obstruction, internal hernia (bypass)","Gastroesophageal reflux (especially after sleeve)","Nutritional deficiencies (iron, B12, vitamin D, calcium, protein)","Dumping syndrome or hypoglycemia","Gallstones","Weight regain or inadequate response","Anesthesia-related complications","Need for reoperation"],"pain":"Moderate postoperative abdominal and shoulder discomfort for several days after laparoscopic surgery, usually controlled with oral analgesics; improves over 1-2 weeks.","preparation":["Multidisciplinary assessment (surgeon, endocrinologist/physician, dietitian, psychologist)","Blood tests, cardiopulmonary assessment, sleep apnea screening as indicated","Upper endoscopy or imaging when indicated","Preoperative liver-reduction diet","Smoking cessation","Fasting before surgery per anesthesia instructions","Education on postoperative diet progression and lifelong supplementation"],"recovery_timeline":[{"phase":"Hospital stay (days 0-3)","description":"Early mobilization, thromboprophylaxis, pain control and start of liquids.","restrictions":["Frequent small sips of fluids","No heavy lifting"]},{"phase":"Early recovery (weeks 1-2)","description":"Liquid then pureed diet; increasing walking; return to light activity.","restrictions":["Avoid lifting heavy objects","Follow staged diet"]},{"phase":"Weeks 2-6","description":"Progression to soft then regular-texture small meals; many return to desk work.","restrictions":["Avoid strenuous exercise and heavy lifting until cleared"]},{"phase":"Months 3-12+","description":"Ongoing weight loss, supplementation and metabolic monitoring; full activity.","restrictions":[]}],"rehabilitation_days":{"min":14,"max":42,"unit":"days","qualifier":"Ordinary functional recovery after uncomplicated laparoscopic surgery; no formal physiotherapy program usually needed."},"result_longevity":"Weight loss and metabolic improvement are generally durable over many years, but some weight regain is common. Lasting results depend on the operation, diet, supplementation and lifelong follow-up.","revision_rate_pct":{"min":3,"max":15,"unit":"percent","qualifier":"Reoperation or conversion for complications, reflux or weight regain within about 5-10 years."},"scars":"Typically several small laparoscopic incisions (about 0.5-1.5 cm) on the abdomen that fade over months; larger scars if open surgery is required.","sessions_or_stages":{"sessions":{"min":1,"max":1,"unit":"visits","qualifier":"Single operation for a primary laparoscopic procedure."},"stages":[{"code":"surgery","label":"Laparoscopic metabolic/bariatric operation","after":{"min":0,"max":0,"unit":"days","qualifier":"Performed on the day of admission."}}],"qualifier":"Primary single-stage operation; staged approaches are exceptional."},"success":{"metric":"Excess weight loss after surgery","value":65,"unit":"percent of excess body weight","horizon":"12-18 months","population":"Adults with severe obesity after primary sleeve gastrectomy or gastric bypass","evidence_status":"proven"},"techniques":[{"name":"Laparoscopic sleeve gastrectomy","suits_whom":"Patients with obesity with or without type 2 diabetes who want a non-bypass option; less suited to severe reflux.","recovery":"Hospital stay about 1-2 nights; return to desk work in about 2-3 weeks."},{"name":"Laparoscopic Roux-en-Y gastric bypass","suits_whom":"Patients with obesity and type 2 diabetes, or significant reflux, often favored for stronger metabolic effect.","recovery":"Hospital stay about 2-3 nights; return to desk work in about 2-4 weeks."},{"name":"One-anastomosis (mini) gastric bypass","suits_whom":"Selected patients with obesity or diabetes; practiced in many centers.","recovery":"Hospital stay about 1-3 nights; similar recovery to gastric bypass."}],"treatment_conditions":["inpatient"],"treatment_duration_hours":{"min":1,"max":3,"unit":"hours","qualifier":"Operating time for one primary laparoscopic operation; sleeve gastrectomy at the shorter end, gastric bypass longer."},"initial_assessment_documents":["Recent HbA1c and fasting glucose results","List of diabetes medications and insulin doses","Previous abdominal surgery reports","Upper endoscopy or gastroscopy report","Recent blood tests with lipid profile"],"travel_trips":{"min":1,"max":1,"one_trip_possible":true,"qualifier":"Single-stage surgery; stay about 7-10 days including 1-3 hospital nights. Follow-up visits usually done remotely or at home."}}},"hrefLanguages":[{"rel":"alternate","hreflang":"ru","language":"ru","href":"https://ru.bookimed.com/clinics/country=dominikanskaya-respublika/procedure=metabolicheskaya-hirurgiya/"}],"questionsAndAnswers":[],"seoTests":{"thin_content":false,"no_txt_after_3_clinics":false},"offerFilters":{"offer_count":0,"price_filter":{"from":0,"to":0,"avg":0}},"leadsCount":{"leads_count":53825},"manualSeo":[],"updatedAt":"2026-10-31T18:14:02.000Z","activeCountries":["DO","TR","TH"],"hasVideoReviewsByContext":false,"hasCriticalApiFallback":false}