Ring-augmented one-anastomosis gastric bypass may not improve weight loss compared to conventional one-anastomosis gastric bypass

1. Ring-augmented one-anastomosis gastric bypass (OAGB) is comparable in safety to conventional OAGB at 1 year.

Evidence Rating Level: 1 (Excellent)

Recurrent weight gain is a major challenge following metabolic bariatric surgery (MBS). There is evidence that adding a ring to sleeve gastrectomy (SG) or Roux-en-Y gastric bypass (RYGB) is safe and may improve long-term weight stability. However, it is unclear whether ring augmentation in one-anastomosis gastric bypass (OAGB) results in similar benefits. This study thus examined whether ring-augmented OAGB improved surgical outcomes compared to conventional OAGB. The study was a 1-year interim analysis of the RiMini trial, a single-center, non-blinded, prospective randomized controlled trial that included adults eligible for primary OAGB. Patients were randomized 1:1 to receive either ring-augmented (Minimizer Ring) or conventional OAGB. The primary outcome of this study was short-term safety of the procedure, including peri- and postoperative complications and adverse events, and secondary outcomes were total and excess weight loss percentages (%TWL and %EWL). In total, 214 patients underwent the intended surgical procedure (mean [SD] age, 43 [11] years; 165 [77%] female; mean [SD] BMI on operation day, 41.6 [6.1] kg/m2). A perioperative complication was reported for one patient in each group (p = 1.00; 0.9%). There was no significant difference in postoperative minor (Clavien Dindo [CD] 1–2) (p = 0.68) or major (CD3–5) (p = 0.77) complications. Additionally, there was no direct causal link to Minimizer ring among patients with adverse events. At 1 year, mean BMI was comparable in both groups (~28kg/m2). There was no significant difference between ring-augmented and conventional OAGB in %TWL (33% vs 31%; p = 0.30), and %EWL (86% vs 84%; p = 0.45). Overall, this study found that ring-augmented OAGB was comparable in safety to conventional OAGB, with no significant difference in weight loss at 1 year.

Click here to read this study in PLOS One

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