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Minimally Invasive Hypoabsorptive Bariatric Surgery - A Systematic Review and Network Meta-Analysis of Randomized
Matthew G Davey1, Noel E Donlon2, Margaret Clerkin3
1Royal College of Surgeons in Ireland, Dublin, Ireland. matthewdavey21@rcsi.ie.
Obesity Surgery
|December 25, 2025
Summary
Comparing bariatric surgeries, Duodenal Switch (DS), Single Anastomosis Duodeno-Ileal Bypass with Sleeve Gastrectomy (SADI-S), and One Anastomosis Gastric Bypass (OAGB) significantly induce weight loss. However, no single hypoabsorptive approach is definitively optimal.
Area of Science:
- Bariatric Surgery
- Obesity Management
- Surgical Innovation
Background:
- The optimal surgical strategy for severe obesity management using hypoabsorptive procedures is not well-established.
- This study addresses the need for comparative data on leading bariatric surgical techniques.
Purpose of the Study:
- To conduct a network meta-analysis (NMA) of randomized clinical trials (RCTs).
- To compare the efficacy of Roux-en-Y gastric bypass (RYGB), SADI-S, OAGB, and DS in severe obesity management.
Main Methods:
- Systematic review adhering to PRISMA-NMA guidelines.
- Inclusion of 12 RCTs with 986 patients.
- Statistical analysis performed using R and Shiny.
Main Results:
- DS and SADI-S showed significantly greater total body weight loss compared to RYGB.
- DS, OAGB, and SADI-S demonstrated significant increases in excess body weight loss versus RYGB.
- DS was associated with increased length of stay; OAGB showed long-term severe malabsorption rates.
Conclusions:
- Duodenal Switch (DS), SADI-S, and OAGB are effective in inducing significant weight loss.
- Limited data for SADI-S due to small sample size.
- No definitive consensus on the optimal hypoabsorptive bariatric surgical approach was reached.
