Analyzing the world's experience in the surgical management of hyperlipidemias and their own results, the authors make an assessment of Buchwald's operation used in the surgery for atherosclerosis obliterans. The major disadvantage of partial ileac bypass is that there is no prognosis of the operation and its complication. Based on the pathophysiological mechanisms of implementation of Buchwald's operation, the authors have developed a mode of pharmacological simulation of a partial bypass which allows one to predict the effect of the impending intervention and to avoid unjustified operations. The unique procedure also enables the indications for simultaneous interventions to be defined. Ten partial ileac bypass surgeries made by the authors are comprehensively analyzed. Taking into account, the authors propose to choose a treatment of patients with hyperlipidemia and atherosclerosis on an individual basis and to do away with the routine indications for partial ileac bypass surgery.