Obesity surgery: Evidence-based guidelines of the European Association for Endoscopic Surgery (EAES)

  • S. Sauerland
  • L. Angrisani
  • M. Belachew
  • J. M. Chevallier
  • F. Favretti
  • N. Finer
  • A. Fingerhut
  • M. Garcia Caballero
  • J. A. Guisado Macias
  • R. Mittermair
  • M. Morino
  • S. Msika
  • F. Rubino
  • R. Tacchino
  • R. Weiner
  • E. A. M. Neugebauer
E.A.E.S. Guidelines



The increasing prevalence of morbid obesity together with the development of laparoscopic approaches has led to a steep rise in the number of bariatric operations. These guidelines intend to define the comparative effectivness and surrounding circumstances of the various types of obesity surgery.


A consensus panel representing the fields of general/endoscopic surgery, nutrition and epidemiology convened to agree on specific questions in obesity surgery. Databases were systematically searched for clinical trial results in order to produce evidence-based recommendations. Following two days of discussion by the experts and a plenary discussion, the final statements were issued.


After the patient’s multidisciplinary evaluation, obesity surgery should be considered in adults with a documented BMI greater than or equal to 35 and related comorbidity, or a BMI of at least 40. In addition to standard laboratory testing, chest radiography, electrocardiography, spirometry, and abdominal ultrasonography, the preoperative evaluation of obesity surgery patients also includes upper gastrointestinal endoscopy or radiologic evaluation with a barium meal. Psychiatric consultation and polysomnography can safely be restricted to patients with clinical symptoms on preoperative screening. Adjustable gastric banding (GB), vertical banded gastroplasty (VBG), Roux-en-Y gastric bypass (RYGB) and biliopancreatic diversion (BPD) are all effective in the treatment of morbid obesity, but differ in degree of weight loss and range of complications. The choice of procedure therefore should be tailored to the individual situation. There is evidence that a laparoscopic approach is advantageous for LAGB, VBG, and GB (and probably also for BPD). Antibiotic and antithromboembolic prophylaxis should be used routinely. Patients should be seen 3 to 8 times during the first postoperative year, 1 to 4 times during the second year and once or twice a year thereafter. Outcome assessment after surgery should include weight loss and maintainance, nutritional status, comorbidities and quality-of-life.


Gastric Bypass Sleeve Gastrectomy Gastric Banding Laparoscopic Adjustable Gastric Banding Excess Weight Loss 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.



The authors thank the E.A.E.S. and its congress president, Prof. Antonio M. Lacy (Barcelona), for the opportunity to compile and present these recommendations. The authors are grateful to Prof. John J. Kelly (Worcester, MA, U.S.A.); Dr. Torsten Olbers (Goteborg, Sweden), and Prof. Antonio M. Lacy (Barcelona, Spain) for valuable comments on a drafted version of the manuscript.


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Copyright information

© Springer Science+Business Media, Inc. 2004

Authors and Affiliations

  • S. Sauerland
    • 1
    • 2
  • L. Angrisani
    • 3
  • M. Belachew
    • 4
  • J. M. Chevallier
    • 5
  • F. Favretti
    • 6
  • N. Finer
    • 7
  • A. Fingerhut
    • 8
  • M. Garcia Caballero
    • 9
  • J. A. Guisado Macias
    • 10
  • R. Mittermair
    • 11
  • M. Morino
    • 12
  • S. Msika
    • 13
  • F. Rubino
    • 14
  • R. Tacchino
    • 15
  • R. Weiner
    • 16
  • E. A. M. Neugebauer
    • 1
    • 2
  1. 1.Conference Organisers on behalf of the Scientific Committee of the European Association for Endoscopic Surgery (E.A.E.S.)VeldhovenThe Netherlands
  2. 2.Biochemical and Experimental Division, Medical FacultyUniversity of CologneGermany
  3. 3.S. Glovanni Bosco HospitalUniversity Federico IINaplesItaly
  4. 4.Service de Chirurgie UniversitaireCHRHBelgium
  5. 5.Department of Digestive and General SurgeryHopital Europeen G PompidouParisFrance
  6. 6.Obesity Unit, Department of Medical and Surgical SciencesUniversity of PadovaVicenzaItaly
  7. 7.Wellcome Clinical Research FacilityAddenbrooke’s HospitalUnited Kingdom
  8. 8.Centre Hospitalier de Poissy-Saint GermainPoissy CedexFrance
  9. 9.Department of SurgeryMalaga UniversitySpain
  10. 10.Mental Health Department, Servicio Extremeno de SaludJunta de ExtremaduraBadajozSpain
  11. 11.Department of General SurgeryUniversity Hospital InnsbruckAustria
  12. 12.Chirurgia Generale II, Department of SurgeryUniversity of TurinItaly
  13. 13.Service de Chirurgie Generale et DigestiveHopital Louis MourierFrance
  14. 14.Department of SurgeryHopitaux UiversitairesFrance
  15. 15.Department of SurgeryCatholic University of RomeItaly
  16. 16.Department of SurgeryKrankenhaus SachsenhausenGermany

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