Introduction: Bariatric surgeries are effective in treating obesity and its associated co-morbidities. The ideal bariatric surgery with satisfactory weight or BMI loss and with few complications and nutritional deficiencies still does not exist. Modifications in one anastomosis gastric bypass (OAGB) and Roux-en-Y gastric bypass (RYGB) are still under study for best BMI loss with few complications. Objective: The aim of the current work was to compare both surgeries, OAGB and RYGB, after limb length modification regarding postoperative complications, resolution of comorbidities, BMI and weight loss, and operative time. Patients and Methods: In this prospective cohort study, we reviewed medical records of 200 patients undergoing mini gastric bypass (MGB) and RYGB with limb length modification. Patients were then followed postoperatively for BMI loss, estimated weight loss, resolution of comorbidities, and postoperative complications. Patients were phone called and asked to attend next day for follow-up. Results: A total of 200 patients were included. Thirteen patients were lost during follow-up. OAGB group has a statistically significant lower BMI and weight at 3, 6, 12, 24 months compared to RYGB group. Regarding operative time, minutes, OAGB group has a significantly lower operative time compared to RYGB group (p=0.0001). Patients who had OAGB had a significantly higher EWL compared to RYGB at 3, 6, 12, 24 months. Regarding resolution of comorbidities and postoperative complications, no significant difference between both groups, MGB vs RYGB (p=0.89) and (p=0.98), respectively. Conclusion: It could be concluded that OAGB is superior to RYGB in BMI and excess weight loss at 3, 6, 12, 24 months, OAGB had lower operative time. No difference between both surgeries in postoperative complications and resolution of comorbidities.

Background: Staple-line leaks after laparoscopic sleeve gastrectomy (LSG) remains a concerning complication in addition to other complications which may occur as bleeding and twisting. Buttressing of the staple line after sleeve gastrectomy is an acceptable reinforcement method but data recorded regarding leaks have been equivocal. Intraoperative measures are used as over-sewing of stapling line to prevent these events and several other methods are used to decrease and control these complications and decrease these burden. Although staple-line reinforcement in several studies is reported to decrease postoperative leakage and bleeding, other studies reported that reinforcement has no role. Authors also reported using buttressing materials. Our study is to compare between sleeve gastrectomy vs. reinforced sleeve gastrectomy with over-sewing of the staple line and omentopexy in morbid obese patients as regards overall complications as bleeding, Leakage and twist.Patients and methods: This prospective randomized Controlled trial involved 500 obese patients conducted during period from January 2018 to January 2019 with follow up till June 2019. The patients were divided into 2 groups, Group A (250 patients) underwent sleeve gastrectomy then reinforcement by suturing of sleeved stomach along the whole length of staple line with omentopexy and Group B (250 patients) underwent sleeve gastrectomy with no over sewing or omental patching.Results: There was a significant difference between the two study groups as regard operative time with longer mean operative time in omentopexy group. However, no statistically significant difference was found between the two study groups as regard post-operative leakage, hemorrhage and twisting although overall complications was less in reinforcement group and leaks detected in reinforcement group are mostly contained leaks but this was statistically insignificant. Conclusion:Minimal advantage is added to sleeve gastrectomy with reinforcement by over-sewing and omentopexy as regard post-operative leakage, hemorrhage and twisting although overall complications was less in reinforcement group and leaks detected in reinforcement group are mostly contained leaks but this was statistically insignificant so further studies is needed with larger sample size.