Gastric Sleeve and Bypass in Seattle

Experienced bariatric surgeons carry out bariatric operations at the clinic:

• 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
• Standard approaches to weight loss have not worked before

BMI serves as the chief indicator of obesity severity. Divide body weight (kg) by height squared (m²) to calculate it. Surgery is normally justified at BMI above 40, or above 35 with serious accompanying conditions. In selected cases it is considered at lower values as well — if non-surgical methods did not help.

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.

City Medical Centre provides four main types of bariatric surgery: sleeve gastrectomy, Roux-en-Y gastric bypass, mini gastric bypass (MGB) and SADI-S duodeno-ileal bypass. We choose each method individually by 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 shifts in stages — liquid, then soft, then solid food. Protein is the priority, while high-calorie, fatty food is limited.

Pregnancy after bariatric surgery is possible, though doctors recommend waiting at least 12–18 months. In that time the body stabilizes, weight reaches its target and nutritional status returns to normal.

Yes, after bariatric surgery vitamins cannot be skipped. As the digestive anatomy changes, some nutrients are absorbed less well, making regular vitamin and mineral supplements a permanent feature of the patient's 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.