Metabolic Reverse Sleeve: Preliminary Results from the First 10 Cases

Laparoscopic sleeve gastrectomy and Roux-en-Y gastric bypass (RYGB) are effective bariatric procedures but are associated with long-term complications, including gastroesophageal reflux and marginal ulcers. The metabolic reversible sleeve (MRS) is a novel, reversible procedure designed to preserve gastric anatomy while providing metabolic benefits. The aim of the current article is to report the safety outcomes of the first 10 consecutive patients undergoing MRS.

Preoperative evaluation included nutritional, psychiatric, and radiological assessments. The operative technique involved laparoscopic gastric bipartition and jejunal bypass, preserving the stomach. Perioperative management followed a standardized protocol. Safety outcomes, including intraoperative complications, postoperative morbidity, and early readmissions, were recorded.

Ten patients (5 females, 5 males; mean BMI: 50.74 kg/m²) underwent MRS. All procedures were completed laparoscopically without conversion. Operative time averaged 159 ± 31 minutes. There were no intraoperative complications. Postoperative recovery was uneventful in all patients: no anastomotic leaks, bleeding, or need for reoperation occurred. All patients were discharged between postoperative day 2 and 3. Early postoperative laboratory values (hemoglobin and C Reactive protein (CRP)) were within expected ranges (mean of hemoglobin = 13.3 ± 1.0 g/dL, mean of CRP = 90.4 ± 36.9 mg/L). Mild, transient nausea occurred in 2 patients and resolved spontaneously.

In this initial series, MRS appears to be a safe and feasible bariatric procedure, with no major perioperative complications. Larger studies with long-term follow-up are required to confirm safety and efficacy.