Background: Obesity is a significant public health issue with increasing global prevalence. Bariatric surgery is currently the most effective intervention for sustained weight loss and improvement in obesity-related comorbidities. This study aimed to compare anthropometric and body composition changes over 24 months following three bariatric procedures, mini-gastric bypass (MGB), sleeve gastrectomy (SG), and Roux-en-Y gastric bypass (RYGB), in an Iranian population. Methods: This study was performed on 6,390 patients who underwent MGB, SG, or RYGB between 2020 and 2022 in Tehran. Anthropometric indices and body composition variables [body mass index (BMI), excess weight loss percentage (EWL%), fat mass, visceral fat, and muscle mass] were measured before surgery and at 3, 6, 12, and 24 months after surgery. Generalized estimating equations (GEEs) were used to assess longitudinal changes and associated factors. Results: All procedures led to significant BMI and EWL% reductions over time (P<0.001). Compared with SG, MGB was associated with a greater BMI reduction and EWL% increase. No significant differences were found in fat mass or visceral fat between the groups, but males showed greater reductions over time. Muscle mass was better preserved in RYGB patients, especially among males. Age and sex were also significant predictors of postsurgical outcomes. Conclusion: Compared with SG, MGB resulted in superior weight loss. RYGB was more effective in preserving muscle mass. Patient characteristics such as age and sex influence surgical outcomes and should be considered in personalized postoperative care.

Surgical Management of weight loss failure after sleeve gastrectomy operations (comparative study between Re-sleeve gastrectomy and Minigastric bypass)

BACKGROUND : Obesity is considered one of the leading global health issues. According to a meta-analysis published in the Lancet, in 2024 there were 880 million adults and 159 million children with obesity worldwide. Surgical treatment is one of the main methods for managing morbid obesity. There are several options for surgical treatment, but mini-gastric bypass is gaining popularity among bariatric surgeries. The operation is considered effective in reducing body mass and achieving remission of obesity-related comorbidities. The main advantage of this type of surgical intervention is the combination of relative simplicity and safety of the operation compared to other shunting bariatric interventions with sufficient efficacy on the course of type 2 diabetes mellitus. Despite the advantages of this technique, there is limited research published in this area. AIM : Assess the long-term outcomes of mini-gastric bypass in patients with morbid obesity. MATERIALS AND METHODS: The study presents the results of a 2-year follow-up of 30 patients who underwent mini-gastric bypass surgery. The patients' average age was 52.5 [50–56.5] years, and their preoperative BMI was 50.0 kg/m 2 [46.2–59.6]. Follow-up assessments were conducted at 6, 12, 18, and 24 months over a two-year period post-surgery. During the observation period, anthropometric data (BMI, waist circumference, hip circumference, excess weight loss percentage — EWL, total weight loss percentage — TWL), fasting blood glucose level, glycated hemoglobin (HbA1c), and postoperative adverse events were evaluated. RESULTS: After two years post-surgery, the median BMI value was 33.6 kg/m2 [28.4–36.5] (p<0.001) with an excess weight loss of 33.6% [28.4–36.4] (p<0.001). The greatest excess weight loss of 35.6% [26.6–54.2] (p<0.001) and 56.0% [39.0–56.0] (p<0.001) was observed at 6 and 12 months of the study, respectively. Similar results were also noted for other parameters. During the study period, remission of type 2 diabetes was achieved in 40% of patients (n=12) at 12 months of observation and in 80% of patients (n=24) at 24 months of observation. A significant reduction in adverse events was observed in the second year of the study compared to the first year. CONCLUSION : Therefore, mini-gastric bypass surgery is an effective bariatric procedure that leads to weight loss and remission of type 2 diabetes.

Background: Bariatric surgery is the only effective procedure that provides long-term sustained weight loss. Sleeve gastrectomy (SG) has emerged over the last few years to be an ideal bariatric procedure because it has several advantages compared to more complex bariatric procedures, including avoiding an intestinal bypass. However, several published follow-up studies report an increased rate of gastroesophageal reflux (GERD) after a SG. GERD is described as either de novo or as being caused by aggravation of preexisting symptoms. The mini-gastric bypass (MGB) with its low complication rates and possibly better long-term results may be a good alternative to SG, especially in super-obesity. Laparoscopic Roux-en-Y gastric bypass (LRYGB) is considered the procedure of choice for patients with morbid obesity with GERD. Patients and Methods: This is a prospective descriptive study including 68 patients scheduled for LSG MGB and RYGB. Patients were divided according to the type of surgery into LSG (25 patients, group 1), MBG (25 patients, group 2) and RYGB( 18 patients, group 3). Patients were evaluated using the Spanish version of the Carlsson-Dent questionnaire. This questionnaire qualitatively evaluates symptoms associated with GERD and their triggering factors such as diet, posture, and medications used. Evaluation done at 6 months and 1 year postoperatively and only symptomatic GERD patients were evaluated by endoscopic based on clinical questionnaires 6 months postoperatively. Results: The results of this study showed that GERD was more prevalent after SG than MGB and RYGB (12(48%),8(32%) and 3(16.6%) respectively after 6 months post operation. After one year, SG remained more prevalent 32.9% compared with MGB and RYGB which were (8% and 5.5%) respectively. Conclusions: LSG might increase the occurrence of GERD in spite of satisfactory weight loss in compare to MGB and RYGB. In addition, MGB and RYGB may lower the risk of postoperative complication such as gastritis and ulcer in compared with LSG as shown by endoscopic follow-up after 6 month post bariatric surgery in asymptomatic patients.

Background: Laparoscopic mini gastric bypass is widely performed for the treatment of morbid obesity due to its metabolic efficacy and technical simplicity. However, concerns remain regarding postoperative bile reflux associated with its loop configuration. Objective: To evaluate the incidence and clinical significance of bile reflux following conventional laparoscopic mini gastric bypass in a single-center cohort. Methods: A retrospective analysis was conducted on 68 consecutive patients who underwent con-ventional mini gastric bypass between 2021 and 2023. Patients were stratified according to pre-operative gastroesophageal reflux status. Early postoperative outcomes were assessed at 30 days, including endoscopic visualization of bile in the gastric pouch and reflux-related symptoms. Mid-term outcomes at 12 months included excess weight loss (%EWL), reflux dynamics, and quality-of-life evaluation. Results: At 30 days, bile was visualized endoscopically in 90.6% of patients with preoperative re-flux and in 47.2% of those without prior reflux (p < 0.001). De novo reflux symptoms developed in 27.8% of previously asymptomatic patients. Most patients in both subgroups achieved ≥50% EWL at 12 months, with greater weight loss seen in those without preoperative reflux. Complete resolution of reflux symptoms occurred in 18.8% of patients with baseline reflux, whereas persis-tent or partially regressed symptoms remained common. Quality-of-life improvement was observed overall but was lower in patients with ongoing reflux manifestations. Conclusion: Conventional mini gastric bypass ensures effective weight loss but is associated with a high incidence of early bile reflux, particularly in patients with preoperative gastroesophageal re-flux disease, and not negligible even in initially asymptomatic individuals.

Abstract Background Gastric emptying studies are important in evaluating patients for candidate for bariatric surgery whom symptomatic for Gerd, allowing for tailored surgical strategies that consider the functional status of the stomach. This careful assessment helps to improve surgical outcomes and enhance overall patient satisfaction in those suffering from GERD with concurrent motility disorders. In patients with GERD who also exhibit delayed gastric emptying, surgical options such as sleeve or mini gastric bypass, SADI, SASI, need careful consideration. Preoperative gastric emptying studies help identify those at risk for postoperative complications such as persistent heart burn or GERD, dysphasia or nausea, which may arise from exacerbated gastric delay. And no contraindication to go for the above-mentioned type if surgeries if the obese patients with GERD having normal gastric emptying. Methods In this study, we are going to conduct a retrospective cohort study designed to investigate the relationship between gastric emptying and the outcomes of surgical interventions, the proper choice of bariatric surgery for patients gastroesophageal reflux disease (GERD).and this will change the strategy that used to be internationally between bariatric surgeons in choosing the proper surgery for obese patients. Gastric emptying will be assessed using scintigraphy before and after various anti-reflux surgeries, including laparoscopic Nissen fundoplication, hiatal hernia repair, and laparoscopic RYGB. And now we use it in our study to assess obese patients with GERD to choose the proper surgical choice with less future complains. And this technique will overcome the upper endoscopy to assess for reflux degree and its relation to surgical options, the study's primary endpoint is to determine whether pre-operative gastric emptying affects the success rate of bariatric surgery. Secondary endpoints include post-operative symptom improvement, complications, and quality of life. The results of this study will provide valuable insights into the role of gastric emptying in the selection of surgical options for obese patients with GERD, ultimately improving clinical outcomes and patient satisfaction. Conclusion The option to do gastric emptying study by using scintigraphy before choosing the type of surgery for obese patients with GERD will affect the surgeon decision and add a high value for the future post operative complications on long run This type of study will change the old ideas in choosing type of surgery and overcome any other tests for GERD.

Obesity is a prevalent health problem in both developed and developing countries. There is no consensus on the incidence of gastro-oesophageal reflux following MGB, and the underlying factors affecting reflux remain unclear. This study aimed to investigate factors that may influence the development of gastro-oesophageal and biliary reflux after MGB surgery. This study was designed as a retrospective cohort study. Patients aged 18-65 years who underwent MGB surgery were included in the study. Reflux symptoms were assessed using the GerdQ questionnaire preoperatively and at 6 months and 1 year postoperatively, and the results were compared. A total of 256 patients were included in the study, with an average age of 44.51 ± 10.07 years. The mean preoperative body mass index (BMI) was 47.8 ± 8.32 kg/m², decreasing to 28.05 ± 5.44 kg/m² at the one-year postoperative mark. The proportion of patients experiencing severe reflux decreased significantly from 42.7% preoperatively to 7.8% at 1 year postoperatively (p < 0.001). However, reflux symptoms at six and twelve months postoperatively were significantly higher in patients with a preoperative hiatal hernia (p < 0.001). Mini gastric bypass surgery is an effective option for managing reflux; however, as symptoms do not improve in patients with a preoperative hiatal hernia, this procedure should be avoided in patients with both gastro-oesophageal reflux and a hiatal hernia. Furthermore, the increased risk of biliary reflux should always be considered in patients with a hiatal hernia but without gastro-oesophageal reflux.

Aim: The aim of our study was to perform morphological and morphometric analysis of biopsy specimens of the common and biliopancreatic loops after gastric bypass with a single anastomosis 3, 12, 24 months after surgery, which included measurement of villi length, ratio of villi length to the thickness of the lamina propria layer containing crypts, estimation of the number and distribution of goblet cells, quantification of number crypts and Paneth cells and comparing the changes in the biliopancreatic and common loops. Materials and Methods: This study included 36 patients who underwent bariatric surgery due to morbid obesity. Patients underwent one of the following procedures: long-loop gastric bypass with one anastomosis, distal gastric bypass with one anastomosis, or mini-gastric bypass. Patients underwent EGDS with mucosal biopsy from the common and biliopancreatic loop at 3, 12, 24 months after gastric bypass with one anastomosis, followed by morphologic and morphometric study of biopsy specimens, which was part of our study. Results: 2 years follow up show statistically significant differences in villus length were observed between the common and biliopancreatic limbs, with the length being greater in the common limb (0.390 ± 0.199 mm) than in the biliopancreatic limb (0.377 ± 0.184 mm) (p < 0.05). These changes may indicate hypertrophy of the villi in the efferent limb to increase the absorptive surface area. The thickness of the basal layer was greater in the biliopancreatic limb than in the common limb, measuring 0.196 ± 0.068 mm versus 0.167 ± 0.043 mm, respectively (p< 0.05). Regulatory functions of Paneth cells were preserved in both groups. Conclusions: Adaptation of the small intestinal mucosa occurs after gastric bypass with one anastomosis, and these changes are more pronounced in the common loop of the small intestine. The regulatory functions of Paneth cells and their number involve both the common loop and the biliopancreatic region.

One anastomosis mini-gastric bypass decreases desacyl ghrelin and improves metabolic profile in male rats with diet-induced obesity.

Acute gastric remnant dilation is a rare but potentially serious complication following mini-gastric bypass (MGB). While the majority of such cases have been reported after Roux-en-Y gastric bypass (RYGB), this case highlights a unique presentation following MGB. Additionally, the potential role of GLP-1 receptor agonists in influencing gastric motility and contributing to postoperative complications is explored. A 44-year-old female with morbid obesity (BMI: 40) underwent laparoscopic MGB after unsuccessful weight loss attempts through lifestyle interventions and liraglutide (Saxenda) use. Postoperatively, the patient developed tachycardia and hypertension without gastrointestinal symptoms. Imaging revealed a dilated gastric remnant with a suspected stricture near surgical clips. Diagnostic laparoscopy identified a mildly kinked pylorus but no definitive obstruction. Despite stricture plasty, the patient continued to experience gastric dilation and required remnant gastrectomy. No mechanical cause was found histopathologically. The patient’s prior use of GLP-1 receptor agonists may have contributed to delayed gastric emptying and the development of this complication. The patient recovered well, achieving significant weight loss (BMI: 28) and metabolic improvement. The case highlights the necessity of precise surgical techniques, mainly stapler placement, to avoid gastric remnant issues after MGB. It also stresses the need to consider the effects of GLP-1 receptor agonists on gastric motility in patients with prior use. Early detection and intervention are vital for preventing serious complications. Preoperative gastric motility evaluation and management of patients on GLP-1 receptor agonists can enhance outcomes, emphasizing the importance of surgical vigilance and technique.

Introduction This study evaluated perioperative changes in serum zinc levels following different bariatric procedures and provided evidence-based recommendations for postoperative monitoring and supplementation. Methods PubMed, Embase, the Cochrane Library, Web of Science and CNKI were systematically searched from inception to July 2025. Eligible studies compared pre- and postoperative serum zinc levels in individuals with obesity undergoing bariatric surgery. Study quality was assessed using the Newcastle–Ottawa Scale (NOS), and the certainty of evidence was graded using the GRADE approach. Pooled analyses were conducted with StataSE 17.0. Results Twelve studies including 2,529 participants were analysed, with overall quality rated as high. Compared with baseline, pooled standardized mean differences (SMDs) in serum zinc at 3 months, 6 months, 1 year, and 2 years postoperatively were −0.12 (95% CI: −0.27 to 0.04, I2 = 57.9%, τ2 = 0.0265, p = 0.149), −0.36 (95% CI: −0.58 to −0.14, I2 = 82.2%, τ2 = 0.1043, p = 0.001), −0.35 (95% CI: −0.53 to −0.16, I2 = 81.9%, τ2 = 0.0769, p = 0.001), and −0.36 (95% CI: −0.95 to 0.24, I2 = 97.2%, τ2 = 0.3515, p = 0.240), respectively. Subgroup analysis showed no significant changes at 3 months across procedures. However, zinc levels significantly decreased at 6 and 12 months after Roux-en-Y gastric bypass (RYGB) and mini-gastric bypass (MGB), but not after sleeve gastrectomy (SG). At 2 years, no significant reduction was observed in any group. The certainty of evidence for zinc changes was rated as moderate. Conclusion Serum zinc levels decline significantly during the first postoperative year, particularly after RYGB and MGB, while SG shows minimal impact. Routine zinc monitoring and individualized supplementation are recommended within the first year after surgery to prevent deficiency-related complications. Registration https://www.crd.york.ac.uk/PROSPERO/view/CRD420251138846

Objective. The aim of the study is to examine the relationship between biliopancreatic limb length and quality of life in obese patients after mini-gastric bypass surgery (GIQLI questionnaire). Materials and Methods. The study included 282 patients who had undergone surgery. The patients were divided into two groups based on the biliopancreatic limb length. The first (main) group comprised 160 morbidly obese patients with a limb length of 150 cm, and the second (comparison) group included 122 patients with a limb length of 180 cm. The groups were comparable in terms of sex, age, BMI, and comorbidities. The Gastrointestinal Quality of Life Index (GIQLI) questionnaire was distributed via Google Forms 24 months postoperatively. Statistical analysis was carried out using the software packages Statistica 12.2 StatSoft (StatSoft, Inc. Tulsa, USA) and SPSS version 21 (SPSS, Chicago, IL, USA). Results. The obtained data demonstrate the dependence of the postoperative patient-reported quality of life assessment on the biliopancreatic limb length. Specifically, the total score on the GIQLI questionnaire was higher in the first group than in the second one. A comparative analysis of the groups by individual components revealed that the scores for psycho-emotional status and social adaptation were comparable (p=0.64 and p=0.8, respectively). However, the differences in physical status were significant: the score for this component in the main group was 57.47±5.35, while in the comparison group it was 46.33±11.41 (p=0.01). Thus, the biliopancreatic limb length significantly influenced the physical condition of the patients, reflecting the problems with the gastrointestinal tract.

Abstract Aim The aim of the study was to evaluate the impact of preoperative GLP-1 agonist medication on postoperative weight-loss outcomes during the first 12 months after bariatric surgery. Method A retrospective, single-centre, cohort study was conducted. A total of 85 adult patients, who underwent primary bariatric surgery (Sleeve Gastrectomy, Roux-en-Y Gastric Bypass, Mini Gastric Bypass) between January and December 2023 and were started on GLP-1 agonists six months before surgery, were included. Patients were grouped based on preoperative use (n=36) or non-use (n=49) of GLP-1 agonists. Primary outcome assessed was the percentage of excess weight loss (%EWL) at 12 months post operative. Statistical analysis was performed using the Mann-Whitney U test. Results Patients using GLP-1 agonists demonstrated significantly greater preoperative excess body weight loss compared to non-users (12.64% vs 6.95%, p=0.015). However, at 12 months postoperative, no significant statistical differences in % EWL between groups, Sleeve Gastrectomy (55.6% vs 48.1%, p=0.148), Mini Gastric Bypass (53.53% vs 51.51%, p=0.356), or Roux-en-Y Gastric Bypass (61.9% vs 56.02%, p=0.148), was noted. Conclusions Although preoperative use of GLP-1 agonists offers in improved weight reduction in preoperative time, but it did not demonstrate any superior short term postoperative weight loss outcomes for bariatric surgery patients. A multi-centre, prospective study having larger sample size with long term follow up may be required to establish and measure long-term implications.

Abstract Aim To assess the incidence of portomesenteric venous thrombosis (PMVT) in a UK regional bariatric centre and conduct a systematic review and meta-analysis comparing PMVT rates in laparoscopic sleeve gastrectomy (LSG) and Roux-en-Y gastric bypass (RYGB). Method A five-year retrospective review (2020–2024) of metabolic bariatric surgery (MBS) cases at a regional UK centre analysed demographics, procedures, PMVT incidence, risk factors, and thromboprophylaxis use. A systematic review and meta-analysis followed PRISMA guidelines comparing PMVT incidence in LSG and RYGB. Statistical analysis was performed using SPSS v22, with meta-analysis in RevMan 5.4. Results The meta-analysis included 14 studies with 105,329 cases (69,767 LSG, 35,562 RYGB). PMVT incidence was 0.24%, significantly higher in LSG (OR 7.13 [3.93,12.92], p&amp;lt;0.0001). Most PMVT occurred within 30 days (OR 21.21 [11.74,38.32], p&amp;lt;0.00001). Risk factors included female gender, contraceptive use, and metabolic syndromes; 13% of PMVT patients had no extended thromboprophylaxis. Mortality was 3.7%. No published UK data on PMVT after LSG or RYGB. In our cohort of 342 patients (LSG 34.8%, RYGB 34.2%, mini gastric bypass [MGB] 31%), routine extended thromboprophylaxis was administered for 2 weeks. No PMVT or VTE events were observed during the follow-up, despite the meta-analysis indicates that most PMVT cases occur within 30 days postoperatively. Conclusions No PMVT cases were reported in our cohort, aligning with the wider UK experience. This raises key questions about surgical technique, thromboprophylaxis protocols, patient selection, or genetic factors underlying the lower UK rates. Further multicentre research is needed to clarify mechanisms and optimise preventive strategies, particularly for LSG patients.

Abstract Background Gastroesophageal reflux disease (GERD) is a frequent and challenging complication following bariatric surgery, often necessitating further intervention. While several surgical strategies exist, the optimal approach for symptomatic hiatus hernia post-bariatric surgery remains under debate. Method We retrospectively reviewed 11 patients who developed symptomatic GERD after bariatric procedures: 7 had undergone sleeve gastrectomy, 3 had a sleeve converted to gastric bypass for reflux, and 1 had a mini-gastric bypass. Presenting symptoms included retrosternal pain, interscapular discomfort, and dysphagia. All patients underwent comprehensive evaluation with upper GI endoscopy, 24-hour pH monitoring, and oesophageal manometry. Each underwent laparoscopic cruroplasty with meticulous oesophageal mobilisation and recreation of the phrenoesophageal ligament. Results All procedures were completed laparoscopically, with an average operative time of 74.6 minutes. The gastroesophageal junction was repositioned intra-abdominally and anchored to the crura. Two patients experienced transient left-sided pneumothorax, managed intraoperatively. Early postoperative follow-up demonstrated symptom control in 82.3% of patients, with sustained improvement in 79% at 18 months. Notably, proton pump inhibitor (PPI) dependence was markedly reduced, and GERD-Q scores improved most significantly in those with prior sleeve gastrectomy compared to gastric bypass. Conclusions Laparoscopic cruroplasty with phrenoesophageal ligament reconstruction is a safe, effective, and durable solution for hiatus hernia repair after bariatric surgery, offering substantial symptomatic relief and reduced medication dependence.

Abstract Aim Bariatric surgery is the most effective long-term obesity treatment. We aim to compare laparoscopic sleeve gastrectomy (LSG) and laparoscopic mini gastric bypass (LMGB) as surgical interventions for morbid obesity, focusing on postoperative weight loss patterns, complications, and long-term efficacy. Method The review synthesizes findings from a comprehensive literature analysis, including retrospective and prospective studies, clinical trials, and meta-analyses. Data were evaluated regarding excess body weight loss (EBWL), complication rates, and postoperative outcomes associated with LSG and LMGB. The technical aspects and physiological effects of both procedures were also assessed. Results Both LSG and LMGB demonstrated effective short- and medium-term outcomes in terms of weight loss and remission of obesity-related comorbidities. LSG resulted in 47–76% EBWL within 1–2 years, with sustained long-term results showing &amp;gt;50% EBWL at 5 years in many studies. LMGB showed comparable or slightly higher EBWL, averaging 65–91% at 1–2 years and 80% at 5 years in some reports. LSG had fewer complications such as nutritional deficiencies but higher incidence of gastroesophageal reflux disease (GERD). LMGB had low rates of bile reflux and marginal ulcers, and showed high patient satisfaction, with shorter operation time and reversibility as added benefits. Conclusions Both LSG and LMGB are effective bariatric procedures for morbid obesity, offering significant weight loss and improvement in comorbidities. While LSG is technically simpler and safer with fewer nutritional deficiencies, LMGB provides slightly superior long-term weight outcomes and patient satisfaction. The choice of procedure should be individualized based on patient risk profile, comorbid conditions, and lifestyle adaptability.

BACKGROUNDOne-anastomosis gastric bypass (OAGB) and sleeve gastrectomy (SG) are surgical procedures increasingly performed for weight loss and to achieve remission of diabetes mellitus. Literature comparing the medium-term efficacy of these two procedures is scarce. As such, a meta-analysis comparing OAGB and SG in terms of diabetes remission (DR) and percentage of excess weight loss (EWL) is warranted.AIMTo compare OAGB and SG in terms of DR and EWL% in the medium term.METHODSA comprehensive literature search was conducted in PubMed/MEDLINE, Cochran Library, and Web of Science for relevant articles, from inception through April 2025, using the keywords “one-anastomosis gastric bypass”, “sleeve gastrectomy”, “mini-gastric bypass”, “diabetes remission”, “one-anastomosis”, and “excess weight loss”. Clinical trials, prospective, retrospective and case-control studies were included; cross-sectional studies, case reports, editorials, and opinions were excluded. The Cochrane Risk of Bias Tool and the Newcastle-Ottawa Scale were used to assess the quality of included studies, and RevMan version 5.4 was used for data analyses.RESULTSA total of 1360 articles were identified, and 35 studies were retrieved of which 32 were included in the final analysis. Three full texts were excluded as they did not include data on DR or EWL%. OAGB achieved higher DR than SG at 1 year following surgery [odds ratio (OR) = 1.77, 95% confidence interval (CI): 1.22-2.57, I2 = 76%]. However, DR rates were similar at 3 years and 5 years following surgery (OR = 0.82, 95%CI: 0.61-1.10, I2 = 23% and OR = 0.92, 95%CI: 0.31-2.72, I2 = 75%, respectively). OAGB showed higher EWL% at 1 year (OR = 9.30, 95%CI: 6.45-12.15, I2 = 91%), 3 years (OR = 10.02, 95%CI: 9.40-10.64, I2 = 22%), and 5 years (OR = 11.61, 95%CI: 3.74-19.48, I2 = 97%). OAGB showed higher late complications than adjustable SG. The results were not different in sub-group analysis including only clinical trials, observational studies, and removing studies including super-obese patients and studies contributing most to heterogeneity.CONCLUSIONIn the medium term, DR rates were similar between OAGB and SG; however, OAGB showed higher EWL% than SG, and late complications were higher in OAGB. Clinical trials investigating the predictors of DR and EWL% are recommended.

Background Obesity is a critical global health challenge and is associated with numerous complications, including type 2 diabetes (T2D), high blood pressure, and cardiovascular diseases. The mini gastric bypass (GB) procedure presents an increasingly popular option for weight loss surgery as an alternative to more traditional GB procedures. This study will look at how effective MGB surgery is to reduce weight, improve blood glucose control, and reduce blood pressure in obese patients at 12 months. Methods A longitudinal cohort study was performed with 50 participants with obesity (BMI ≥ 30), scheduled for MGB surgery. Subjects were evaluated at four time points: pre-operatively, and at 3, 6, and 12 months post-operatively. The main variables studied were weight (kg), blood glucose (mg/dL) blood pressure (mm Hg), systolic and diastolic. The descriptive analysis was performed for each variable, and normality was investigated using the Shapiro-Wilk test. Paired t-tests, specifically with consideration of the Shapiro-Wilk test for normality, or repeated measures ANOVA as appropriate, were conducted to define the significance of changes in health parameters over time. Results The median weight loss was 30 kg at 12 months after surgery. Glycemic control improved compared to the period preoperative, as indicated by a reduction in blood glucose from a mean of 158 mg/dL to a mean of 120 mg/dL in the 12th month. Systolic BP also decreased from 151 mmHg before surgery to 130 mmHg at 1 year. Moreover, after this period, diastolic blood pressure decreased from 93.6 mmHg to 77.2 mmHg. Each of the variables decreased in value over time, and changes were most substantial in the first 6 months after surgery. Conclusion The main indications for MGB operation are morbid obesity, uncontrolled blood glucose level, and uncontrolled blood pressure. These results indicate that the MGB could be a good treatment modality for patients with severe obesity and its comorbidities. However, larger research studies with long-term follow-ups are needed to validate these findings and examine the long-term sustainability of these advantages.

To evaluate 3-year follow-up data after SLIM-OAGB considering reduction of excess body weight, quality of life and severity of postoperative reflux; to compare these indicators with a representative group of patients who underwent standard mini-gastric bypass (MGB-OAGB). To analyze loss of excess body weight, quality of life and severity of reflux, we used the SF-36, BAROS and GERD-HRQL systems to survey patients after SLIM-OAGB. Results were evaluated and compared with literature data on the incidence of reflux and weight loss after other bariatric interventions. Between June 2019 and December 2023, 396 patients aged 18-69 years underwent SLIM-OAGB; 32.3% of patients (n=128) participated in survey. Of these, 6 (4.7%) were men, 122 (95.3%) were women. At baseline, mean body weight was 92.47±11.3 kg (from 67 to 125 kg), BMI - 33.9±3.8 kg/m2 (from 25.46 to 46.07 kg/m2). In 6 months after surgery, BMI was normal in all patients. After 1 year, this value was 24.4±3.52 kg/m2 (17.79-36.26 kg/m2), in patients with class I obesity - 23.2±2.33 kg/m2 (17.99-27.63 kg/m2). In 2 years after surgery, mean BMI was 23.3±3.38 km/m2 (18.36-31.25 km/m2), in patients with class I obesity - 22.33±2.5 kg/m2 (19.05-26.30 kg/m2). After 3 years, mean BMI was 22.03±2.9 kg/m2 (17.57-25.21 kg/m2), in patients with class I obesity - 22.39±3.1 kg/m2 (18.42-25.21 kg/m2). Mean %EWL value after 1 year was 117.72±46.6% (from 32.41 to 333.42%), in class I obesity- 126.4±33.4% (from 71.13 to 194.33%), after 2 years - 133.15±48.2% (from 69.81 to 254.55%), in class I obesity - 139.9±38.2% (from 82.76 to 207.14%). Mean %TWL after 1 year was 27.97±7.79% (12.96-45.26 %), in class I obesity - 28.44±6.91% (14.77-45.26%), after 2 years - 31.65±8.1% (14.29-45.92%), in class I obesity - 30.10±8.1% (16.67-41.18%), after 3 years - 31.54±6.3% (20.9-40.23), in class I obesity - 32.85±6.4% (26.53-40.23%). Fifty (39.06%) patients rated their health status as excellent, 27 (21.09%) - as very good, 35 (27.34%) - good, 4 (3.13%) - mediocre. Symptoms of reflux were observed in 7 (5.47%) patients. We surveyed 438 patients after MGB-OAGB operated on in 2019-2023. Clinical manifestations of reflux were observed in 25 patients (5.71%). Five (20%) patients after MGB-OAGB and 1 (14.3%) patient after SLIM-OAGB complained of reflux significantly reducing the quality of life (GERD-HRQL score 5). SLIM-OAGB is highly effective in the treatment of obesity class 1 and II with loss of excess body weight in long-term postoperative period (3 years after intervention) and significant improvement of the quality of life. The incidence of biliary gastrointestinal reflux after SLIM-OAGB and MGB-OAGB was almost the same (5.47%).

To evaluate the safety, efficacy, and long-term outcomes of concomitant laparoscopic bariatric surgery and ventral hernia repair in obese patients. Obesity and ventral hernia frequently coexist, often presenting a surgical dilemma. Historically, concerns over mesh infections, extended operative time, and increased morbidity have led to a preference for staged procedures. However, with advancements in laparoscopic techniques and increasing evidence supporting mesh placement in clean-contaminated fields, the concomitant approach has gained acceptance. High-quality data from large-volume centers remain limited till now. This retrospective study was conducted at a tertiary care center between January 2003 and December 2023. A total of 353 patients underwent simultaneous bariatric surgery-either laparoscopic sleeve gastrectomy (LSG), Roux-en-Y gastric bypass (LRYGB), or mini-gastric bypass (MGB-OAGB)-with ventral hernia repair using intraperitoneal onlay mesh (IPOM), eTEP-Ventral RS, or eTEP-TAR techniques. The Primary objective of the study was to assess the complication and recurrence rates. Secondary objective included operative time, hospital stay, and postoperative recovery. Of the 353 patients, 224 underwent LSG, 74 LRYGB, and 55 MGB-OAGB. IPOM was used in 90% of cases. The overall complication rate was low, with seroma (2.3%), ileus (2.6%), hematoma (1.1%) and Surgical site occurrences (SSO) (3.4%) being the most common. No mesh infections or anastomotic leaks were observed. Mean operative time ranged from 124 to 167min, and average hospital stay was 3.1 ± 1.1 days. At one-year follow-up in 268 patients (80%), hernia recurrence was 0.6%. Concomitant laparoscopic bariatric surgery with hernia repair is a safe and effective option in appropriately selected patients, with excellent outcomes and minimal complications.