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. 2025 Aug;35(8):3013-3019.
doi: 10.1007/s11695-025-07988-1. Epub 2025 Jun 26.

A Ring-Augmented Roux-en-Y Gastric Bypass with MiniMizer Ring is Effective and Safe in Patients with a BMI >50 kg/m2

Marijn T F Jense  1   2 , Kick Bluijssen  3   4 , Evelien De Witte  4   5 , Pieter P H L Broos  4   5 , Boudewijn E Schaafsma  4   5 , Jan Willem M Greve  6 , Evert-Jan G Boerma  4   5
Affiliations

A Ring-Augmented Roux-en-Y Gastric Bypass with MiniMizer Ring is Effective and Safe in Patients with a BMI >50 kg/m2

Marijn T F Jense et al. Obes Surg. 2025 Aug.

Abstract

Background: The Roux-en-Y gastric bypass (RYGB) is regarded as one of the most effective treatments for obesity. The ring-augmented RYGB (raRYGB), has demonstrated superior long-term weight loss outcomes and better weight maintenance compared to the standard RYGB. There is no agreement regarding the optimal procedure for patients with a BMI >50 kg/m2. This study aims to evaluate the effectiveness and safety of ring augmentation of a RYGB with a MiniMizer ring in patients with a BMI >50 kg/m2 at 2-year follow-up.

Methods: This study is a retrospective cohort study performed at the Zuyderland Medical Center in Heerlen and the Nederlandse Obesitas Kliniek Zuid. All patients with a BMI >50 kg/m2 who underwent a raRYGB with a MiniMizer ring in the period 2016-2021 are included. Total weight loss (TWL), obesity-related complications, and surgical-related complications were analyzed over 2 years post-operative.

Results: A total of 171 patients were included, of whom 78.4% were female, with a median BMI of 54.0 kg/m2 (51.4-57.7 IQR) and age of 42 (32-52 IQR) years at baseline. The mean % TWL was 15.6 at 3 months, 24.8 at 6 months, 32.1 at 1 year, and 35.2 at 2 years post-operatively. Complications of Clavien Dindo 3 or higher within the first 30 post-operative days were seen in 8 patients (4.7%) of which 1 (0.6%) was ring related.

Conclusions: The raRYGB with a MiniMizer ring in this study population results in high total weight loss results after 2 years. Ring-related complications rates are low. Therefore, we conclude that a raRYGB is an effective and safe treatment option for patients with a BMI >50 kg/m2.

Keywords: BMI over 50 kg/m2; Banded Roux-en-Y gastric bypass; Banded bypass; Banded gastric bypass; Ring-augmented gastric bypass; Severe obesity.

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Conflict of interest statement

Declarations. Ethics Approval: The study was presented to the medical ethics committee METC Zuyderland Zuyd who waived the need for ethical approval under Dutch law. The study has been performed in accordance with the ethical standards as stated in Dutch law. Informed Consent: A waiver for additional informed consent was obtained by the local medical ethics committee. Competing interests: The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Boxplot graph presenting total weight loss results over time. IQR = interquartile range; SD = standard deviation
See this image and copyright information in PMC

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