Abstract
The Roux-en-Y gastric bypass (RYGB) has been considered a gold standard procedure in bariatric surgery for many years and yet there is no definite standardisation1.
 RYGB has a small gastric pouch, different biliopancreatic limb lengths, Roux limb [alimentary limb] and the common channel. Standardization of the procedure is suggested in the 2019 Bhandari et al study2. It suggested <30mls gastric pouch capacity, the total length of BPL and the Roux limb is 200cm with each limb could be 50-150cm. There was no mention of the common channel length.
 The proximal RYGB with short BPL is expected to be associated with an increasing risk of failure, weight regain and relapse of the comorbidities, while the distal type is associated with severe hypoproteinaemia, malnutrition, liver failure and increasing risk of mortality, but superior efficacy3. The adjustment of the BPL and bypassed intestinal length is the safety and efficacy key factor for both OAGB and RYGB.
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