Paris (AFP)

The High Health Authority (HAS) wants to further control the safety of obesity surgery: it will assess the various emerging techniques and advocates the disbursement of a procedure already widely practiced, she said Monday.

The HAS, whose opinions determine reimbursements by the Secu, is "unfavorable" to the "gastric bypass omega", she said in a statement.

The omega bypass is a particular form of one of the most used techniques, the bypass. This involves reducing the size of the stomach and bypassing part of the small intestine.

This short circuit was first made Y-shaped: it is called "bypass Y," recommended by the HAS.

But "another" so-called "omega + technique has spread widely over the past few years because it is" simpler to carry out, "says HAS.

This technique is so far reimbursed because the text of the Health Insurance mentions the bypass in general, without precision.

On the basis of recently published results, the HAS judges that the omega bypass "does not represent a relevant alternative to the Y bypass" and recommends that it "not be reimbursed by the Health Insurance".

With an omega bypass, "studies reveal a greater number of serious complications, including severe deficiencies, including vitamins and minerals, bile reflux," according to the HAS.

For patients who have already been operated on with an omega bypass, the HAS recommends "particular vigilance on the occurrence of nutritional and biliary reflux complications - the long-term consequences of which are unknown". She advocates "in particular fibroscopy five years after surgery".

In addition, the HAS states that it will "evaluate the relevance, efficacy and safety of bariatric surgery techniques other than the four currently recommended (gastric band, sleeve, Y-bypass and bypass"). pancreaticobiliary) ".

Its goal: "To make an inventory of the techniques currently in development", in order to "evaluate them before they are diffused in the current practice".

Obesity surgery has exploded in France in the last 20 years. "Each year, more than 50,000 people are operated," recalls the HAS, according to which the most used techniques are the sleeve (32,000 per year, during which one removes a large part of the stomach) and bypass (13,000 per year).

The HAS finally insists that surgery should be reserved for "morbid" obesity (body mass index greater than 40), even for those with a BMI of 35 or more in case of serious complications due to excess weight. , and after failure of other means, including dietary.

"This heavy act must only be carried out after a shared medical decision, with clear information on existing techniques, their advantages and disadvantages, their consequences, complications and the need for medical follow-up. throughout life, "she says.

© 2019 AFP