Bariatric Surgery in Milan: Methods and Results

Yes, bariatric surgery is the medical term for it. At City Medical Centre the main methods are sleeve gastrectomy (gastric sleeve) and gastric bypass; the surgeon chooses the method by your BMI and health.

Usually a BMI over 40, or over 35 with related health conditions. The surgeon confirms whether surgery suits you at the consultation.

At the clinic, bariatric operations are carried out by experienced bariatric surgeons:

• Ruslan S. Menzulin — bariatric surgeon and surgical oncologist, 9 years of experience. Trained at Mercy clinic (USA) under Vadim Gushchin, spoke at the World Congress of bariatric surgery in Santiago (2025). Co-author of an international study published in The Lancet.
• Andrey G. Ugay — lead bariatric surgeon, 27 years of experience. Has performed the largest number of SASJ operations in the country. Expert council member of the national Society of Bariatric Surgeons.

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Surgery is prescribed only when clear criteria are met

• The patient's body mass index (BMI)
• Overall health and any related chronic conditions
• Conventional weight-loss methods have failed in past attempts

BMI is the primary tool for judging obesity. The formula: body weight (kg) divided by height squared (m²). Surgery is typically justified at a BMI above 40, or above 35 if there are serious related conditions. At times surgery is also considered with lower figures — provided non-surgical treatment has failed.

Though often confused, the two have fundamentally different goals. Bariatric surgery is a medical treatment of obesity and related illnesses; it changes the functioning of the digestive tract to address the causes of excess weight and metabolism. Plastic surgery reshapes the outer contours of the body and neither treats obesity nor affects metabolism.

At City Medical Centre there are four main types of bariatric surgery — sleeve gastrectomy, Roux-en-Y gastric bypass, mini gastric bypass (MGB) and SADI-S duodeno-ileal bypass. Every method is chosen individually from BMI, related conditions and the patient's goals.

We rely on modern laparoscopic technique. The operation is performed through 4 small punctures of 5 to 15 mm. Cosmetic sutures are used, so after healing the marks are barely visible.

Recovery time depends on the activity. Office work: after 2–4 weeks. Physical work: after 1.5 months. Sport and activity: swimming allowed after 30 days, other exercise gradually added as weight goes down. Travel and holidays: plan no sooner than one month after surgery.

The diet evolves in steps — from liquids to soft, then solid food — with a focus on protein and limits on high-calorie, fatty food.

Pregnancy after bariatric surgery can happen, though doctors advise holding off at least 12–18 months. In this period the body becomes stable, weight reaches target values and nutritional status normalizes.

Yes — vitamins are required after bariatric surgery. With the digestive anatomy changed, some nutrients are absorbed less well, and regular vitamin and mineral supplements become a permanent part of life.

After bariatric surgery weight regain can happen, but it is very unlikely if the doctor's advice is followed. What matters is proper nutrition, avoiding high-calorie drinks and regular follow-up with City Medical Centre specialists.