One-anastomosis gastric bypass (OAGB)
OAGB connects a stomach pouch to an intestinal loop with one anastomosis. Its anatomy differs from Roux-en-Y. Reflux, including bile reflux, nutritional effects and possible future conversion should be discussed explicitly.
SADI-S
Single-anastomosis duodeno-ileal bypass with sleeve gastrectomy combines a sleeve with a loop connection from the duodenum to the ileum. It differs from the two-anastomosis BPD-DS. Protein intake, vitamin monitoring, bowel effects and reflux remain important considerations.
Endoscopic therapies
Selected stomach or outlet procedures can be performed through an endoscope. Their role depends on the original anatomy and treatment goal. Endoscopic sleeve gastroplasty does not remove stomach tissue and is different from surgical sleeve gastrectomy. An outlet revision after bypass is another distinct procedure.
Adjustable gastric band
A band restricts the upper stomach and can be adjusted through a port. Existing bands may require adjustment, removal or conversion because of intolerance or device problems. A selected indication must be weighed against the possibility of further procedures.
Metabolic omentectomy: evidence and limitations
Removal of omental fat has been studied as a metabolic intervention. Early pilot findings were encouraging, but later randomized trials did not show a consistent additional improvement in insulin sensitivity when omentectomy was added to gastric bypass. It should not be presented as an established equivalent to sleeve, bypass or DS, or as a reliably effective stand-alone treatment for metabolic disease.
Research: 2002 pilot trial; 2010 randomized trial; 2014 randomized trial with two-year follow-up.
Discuss which options are appropriate and available for your anatomy and goals at consultation. See revisional surgery for conversions and reversals.
Further reading: ASMBS: bariatric surgery procedures. Procedure selection and follow-up are individualized.