Key result
Ring-augmented RYGB linked to ~3.6% greater total weight loss at 5 years versus standard bypass.
Why the study?
Studies comparing ring-augmented Roux-en-Y gastric bypass with regular Roux-en-Y gastric bypass have used varying ring types, leading to heterogeneous long-term weight loss results.
Does ring-augmented Roux-en-Y gastric bypass improve percentage total weight loss at 5 years compared to regular Roux-en-Y gastric bypass in patients undergoing bariatric surgery?
Cohort (n=592)
Yes
Does ring-augmented Roux-en-Y gastric bypass improve percentage total weight loss at 5 years compared to regular Roux-en-Y gastric bypass in patients undergoing bariatric surgery?
Mean Difference: 3.59 (95% CI 2.09–5.09)
Absolute Event Rate: 31.5% vs 28%
p-value: p=<0.01
Ring-augmented Roux-en-Y gastric bypass is associated with greater 5-year weight loss and lower recurrent weight gain compared to standard RYGB, with a 4% rate of ring-related reoperations.
May support ring augmentation for durable post-RYGB weight loss; leaves open confirmation of net benefit in randomized trials.
BACKGROUND: The ring-augmented Roux-en-Y gastric bypass (raRYGB) has been reported to result in higher long-term weight loss compared to regular Roux-en-Y gastric bypass (RYGB). However, the type of ring used varied within studies, leading to heterogeneity in reported results. Therefore, this study compares the 5-year results of RYGB with and without ring augmentation using a specific prefabricated gastric ring. METHODS: All consecutive patients from a single center who received primary raRYGB between June 1, 2016, and May 31, 2018, with complete 5-year follow-up data were included and compared to a propensity score matched cohort receiving RYGB in the same period from the Dutch Audit for Treatment of Obesity. To ensure fair effect estimation of placing a ring, only RYGB procedures with alimentary and biliopancreatic limb lengths similar to those of the raRYGB were considered eligible. The primary outcome was percentage total weight loss (%TWL). Secondary outcomes included recurrent weight gain (RWG), obesity complication improvement, and complications. RESULTS: In total, 592 matched patients were analyzed. raRYGB was associated with higher %TWL at 5 years (31.5% versus 28.0%, β = 3.59, 95% CI [2.09-5.09], p < 0.01) and lower odds on RWG (odds ratio = 0.56, 95% CI [0.38-0.83], p < 0.01). Improvement of obesity complications and short-term complication rates were comparable in both groups. After 5 years, 13 patients (4%) had experienced ring-related complications needing reoperation. CONCLUSIONS: At 5 years, raRYGB was associated with higher %TWL and lower odds on RWG. The occurrence of ring-related complications was limited.
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Jense et al. (2025) conducted a cohort in Morbid obesity (n=592). Ring-augmented Roux-en-Y gastric bypass (raRYGB) vs. Regular Roux-en-Y gastric bypass (RYGB) was evaluated on Percentage total weight loss (%TWL) at 5 years (β = 3.59, 95% CI 2.09-5.09, p=<0.01). Ring-augmented Roux-en-Y gastric bypass was associated with a significantly higher percentage total weight loss at 5 years compared to standard bypass (31.5% vs 28.0%, MD 3.59).
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