Weight Loss Surgery in Sofia: Sleeve, Bypass, SADI-S

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.

Our clinic's bariatric operations are performed 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.

Send us a message to have our coordinator contact you shortly and book your consultation; the bariatric surgeon consultation costs nothing.

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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
• Previous efforts at weight loss through standard methods did not work

The main way to assess the degree of obesity is BMI. It is body weight (kg) divided by height squared (m²). Generally, surgery is justified with BMI above 40, or above 35 combined with serious related conditions. Lower values may sometimes be considered for surgery too, when non-surgical measures have failed.

It is common to confuse them, but their goals are fundamentally different. Bariatric surgery treats obesity and related diseases medically. By changing how the digestive tract works, it addresses the causes of excess weight and metabolism. Plastic surgery shapes the body's outer contours; it does not treat obesity and has no effect on metabolism.

City Medical Centre carries out four main types of bariatric surgery: sleeve gastrectomy, Roux-en-Y gastric bypass, mini gastric bypass (MGB) and SADI-S duodeno-ileal bypass. The choice of method is individual, based on BMI, related conditions and the patient's goals.

Using modern laparoscopic technique, we perform the operation via 4 small punctures of 5 to 15 mm. Cosmetic sutures are placed, leaving marks that are nearly invisible after healing.

How soon you recover depends on what you do. Office work: 2–4 weeks later. Physical work: 1.5 months later. Sport and activity: swimming from day 30, other exercise brought in gradually as weight falls. Travel and holidays: ideally not sooner than a month after surgery.

Eating changes gradually: liquid food first, then soft, then solid. The focus is protein, with high-calorie, fatty food kept to a minimum.

Pregnancy is an option after bariatric surgery, but doctors advise waiting at least 12–18 months. By then the body has stabilized, weight has reached target values and nutritional status has normalized.

Yes, vitamins are essential after bariatric surgery. As digestive anatomy changes, the body absorbs certain nutrients less well, so regular vitamin and mineral supplements become a lasting part of the patient's life.

Weight can come back after bariatric surgery, but this is very unlikely if you follow your doctor's advice. Proper nutrition, skipping high-calorie drinks and regular follow-up with City Medical Centre specialists are key.