Mise au point medicale avant gastroplastie: indications et contre-indications.

Because of the common failure of the various medical procedures used for the treatment of morbid obesity, surgeons have searched alternatives among which gastroplasty appears to offer now the best efficacy/safety ratio. Such approach has become more and more popular in our country, but success is almost highly variable from patient to patient. A careful medical assessment is necessary before performing gastroplasty. It mainly aims at choosing the appropriate indications (failure of previous well-applied medical therapy, exclusion of any hormonal cause of obesity, presence of complications due to weight excess, ...) and at excluding cardiovascular (unstable coronaropathy, carotid stenosis, ...), digestive (recurrent oesophagitis, ...) or psychiatric contra-indications. Such medical assessment before gastroplasty should allow to increase the success rate and to reduce the incidence of complications after the surgical procedure.