Types of Bariatric Surgery: Complete Guide 2026

Bariatric surgery has evolved considerably in recent decades. Today there are several procedures with different degrees of invasiveness, reversibility and effectiveness. Dr. César Hernández Elenes in Mexicali explains the main types of bariatric surgery so you understand the options available and which could be right for you.

General classification

Bariatric surgeries are classified into three groups according to their mechanism: restrictive (reduce stomach size, such as gastric sleeve and gastric band), malabsorptive (alter intestinal absorption, today rarely used alone) and mixed (combine both mechanisms, such as gastric bypass and duodenal switch). Each group has specific advantages, risks and indications.

Gastric sleeve (vertical gastrectomy)

The most performed bariatric procedure in the world. It consists of removing approximately 80% of the stomach, leaving a narrow banana-shaped tube. It reduces gastric capacity and eliminates most of the ghrelin-producing cells (hunger hormone). Expected loss: 60-70% of excess weight in 12-18 months. Low surgical risk, fast recovery, no implants required, definitive but does not alter intestinal anatomy.

Roux-en-Y gastric bypass

Mixed procedure considered the "gold standard" for patients with type 2 diabetes and severe reflux. A small gastric pouch is created and connected directly to a loop of small intestine, bypassing the lower stomach and duodenum. Expected loss: 70-80% of excess weight. Better diabetes control than sleeve, but technically more complex and with higher risk of nutritional deficiencies.

One-anastomosis gastric bypass (mini-bypass)

Simpler variant of Roux-en-Y bypass. Uses a single intestinal junction, reducing surgical time and technical complications. Results comparable to Y bypass in weight loss and metabolic control. Good option for patients with very high BMI or long-standing diabetes.

Intragastric balloon

Non-surgical endoscopic procedure. A silicone balloon filled with saline solution is placed in the stomach endoscopically and removed after 6 or 12 months. Expected loss: 10-15% of body weight. It is temporary, reversible, ideal for patients with overweight (BMI 27-32) or as preparation for major surgery.

Endoscopic gastroplasty

Minimally invasive technique where the stomach is folded from the inside using endoscopic sutures, without external cuts. Reduces gastric volume by approximately 70%. Does not require prolonged hospitalization. Expected loss: 15-20% of body weight. Good option for patients with BMI 30-35 who prefer to avoid surgery.

Adjustable gastric band

An adjustable silicone ring is placed around the upper part of the stomach. Today it is considered obsolete in most bariatric centers due to frequent complications, slippage and inferior long-term results. Many patients with bands are re-operated to convert to sleeve or bypass.

Duodenal switch

More complex procedure with greater weight loss (75-85% of excess). Combines a gastric sleeve with an extensive intestinal bypass. Reserved for patients with extreme obesity (BMI >50) or failure of previous surgeries. Requires lifelong nutritional supplementation.

Which is the best option for you?

The choice depends on your BMI, comorbidities (diabetes, reflux, sleep apnea), age, eating habits and personal preferences. For most patients with obesity (BMI 30-45), gastric sleeve offers the best balance between effectiveness, safety and subsequent quality of life. During consultation with Dr. César Hernández, your complete profile is evaluated to recommend the most appropriate procedure.