Metabolic surgery
"Metabolic surgery has been shown to be beneficial not only for the control of diabetes, but also for the resolution of associated diseases".
DR. VÍCTOR VALENTÍ CODIRECTOR. AREA OF OBESITY
Surgery for type 2 diabetes and obesity
Metabolic surgery uses procedures on the digestive system to treat obesity and improve associated metabolic conditions, especially type 2 diabetes. It uses the same techniques as bariatric surgery, with a particular focus on their effects on blood glucose control.
These procedures change the capacity of the stomach and, in some techniques, the route food takes through the intestine. In addition to promoting weight loss, they alter digestive signals involved in appetite and metabolism.
Clínica Universidad de Navarra has an Obesity Department that brings together professionals from different specialties. It holds the IFSO and EASO accreditations listed in its institutional information on obesity treatment and bariatric and metabolic surgery.
International Center of Excellence in Metabolic Surgery
Accredited by the International Federation for the Surgery of Obesity and Metabolic Disorders (IFSO)
Experience
More than 20 years of experience in the treatment of obesity surgery.
Expert professionals
Trained at leading national and international centers.
Prompt assessment
A comprehensive assessment can be completed within 48 hours so we can offer you the best treatment tailored to your needs.
Safety
Bariatric surgery is safe, with a low complication rate.
Fast recovery
Laparoscopic and robotic approaches allow for a fast recovery. Patients are discharged after 48 hours.
Personalized program
Guidance and follow-up from the entire team before and after surgery.
When is metabolic surgery indicated?
Metabolic surgery may be considered for adults with type 2 diabetes and a body mass index (BMI) of 30 kg/m² or higher, provided they are suitable candidates for surgery. The American Diabetes Association includes this option in its 2026 recommendations.
For people with a BMI between 30 and 34.9 kg/m², the ASMBS and IFSO recommendations support considering surgery when nonsurgical treatments do not achieve sufficient, lasting weight loss or adequate improvement in associated conditions.
BMI alone does not determine the need for surgery. The decision requires an individual assessment of health, previous treatments, expected benefits, and surgical risk. Nutritional and psychological status, as well as the ability to maintain follow-up care, must also be assessed.
Most frequent indications of this treatment:
Do you have type 2 diabetes and obesity?
Schedule an evaluation with our specialists to find out which treatment options may be right for you.
How is metabolic surgery performed?
Types of surgical techniques for diabetes
Several surgical techniques are currently available, depending on the patient’s individual characteristics.
The choice is tailored to each patient. Each procedure offers benefits and has limitations that should be discussed with the patient before surgery.
Surgery is usually performed laparoscopically, through small incisions in the abdomen, under general anesthesia. At Clínica Universidad de Navarra, a robotic approach is also used.
Laparoscopic gastric bypass
Gastric bypass involves creating a small pouch in the upper part of the stomach and connecting it to the small intestine. This allows food to bypass part of the stomach and intestine.
This change reduces the amount of food that can be eaten and alters digestive signals related to metabolism.
It is one of the techniques with evidence of improved type 2 diabetes control. Long-term follow-up studies that include this procedure show a reduced need for medication and a greater likelihood of remission compared with the medical treatment and lifestyle changes evaluated in those trials.
Laparoscopic sleeve gastrectomy
Sleeve gastrectomy, also called vertical sleeve gastrectomy, involves removing approximately 80% of the stomach, leaving a tube-shaped structure. It does not change the route food takes through the intestine.
In addition to reducing the stomach’s capacity, it affects the hormonal signals that regulate hunger, fullness, and blood glucose control. It can improve type 2 diabetes, although its metabolic effects may be less pronounced than those of bypass procedures.
Gastroesophageal reflux should be taken into account when choosing this procedure, as it can develop or worsen afterward.
SADI-S: single-anastomosis duodeno-ileal bypass with sleeve gastrectomy
SADI-S combines a sleeve gastrectomy with an intestinal bypass. After reducing the size of the stomach, the duodenum is connected to a section farther along the small intestine through a single connection.
It can achieve substantial weight loss and improve type 2 diabetes control. It may also be used in selected patients who have already undergone sleeve gastrectomy and need additional surgical treatment.
Its effect on nutrient absorption requires particular attention to nutritional follow-up. Potential drawbacks include vitamin and mineral deficiencies, reflux, and more frequent or looser stools. The decision to perform this procedure must be individualized.
Revisional surgery
In some patients, another procedure may be considered after previous surgery because of weight regain, insufficient weight loss, inadequate improvement in associated conditions, or complications.
Revisional surgery is more complex than the initial procedure. A specialist evaluation is required to determine the causes of the problem and the most appropriate treatment option.
Preparation and recovery after metabolic surgery
Preparing for metabolic surgery
Before surgery, you will undergo a medical, nutritional, and psychological evaluation. The team will review your medical history, order the necessary tests, and help you prepare for the dietary and lifestyle changes required for the procedure.
Preparation includes an individualized nutrition plan, quitting smoking if you smoke, and a review of your regular medications.
Postoperative care
Food is gradually reintroduced following the nutrition team’s guidance. During recovery, you will need to follow your individualized recommendations for hydration, medication, and physical activity.
Long-term follow-up is essential. It includes assessing diabetes control, nutritional status, and changes in weight, along with the prescribed supplements to prevent deficiencies. It also helps detect episodes of hypoglycemia, or blood glucose levels that are too low, and other complications.
The Obesity Area
of the Clínica Universidad de Navarra
Our Obesity Area is formed by a team of professionals from different specialties. In less than 48 hours we perform the complete evaluation of a patient by all specialists according to our obesity protocol.
The Clinic is a center of excellence accredited in the treatment and surgery of obesity by the European Society for the Study of Obesity and by the International Federation for Bariatric Surgery.
What diseases do we treat?
- Metabolic syndrome
- Overweight
- Obesity
- Morbidly obese
- Childhood obesity
What treatments do we perform?
- Medical plan and personalized nutritional follow-up
- Intragastric balloon
- Bariatric surgery
- Endoscopic techniques
- Metabolic surgery
- Revision surgery
Why at the Clinica?
- More than 20 years of experience in the treatment of obesity surgery.
- Trained in these techniques in international reference centers in the USA and Europe.
- In 48 hours our specialists will evaluate your case and propose the best treatment.
Our team of professionals
Specialists in the Obesity Area with experience in metabolic surgery
