Effectiveness and Safety of Ring-Augmented RYGB with MiniMizer Ring in BMI ≥50
Overview
This retrospective study evaluated ring-augmented Roux-en-Y gastric bypass (raRYGB) with a MiniMizer ring in patients with BMI ≥ 50 kg/m2, demonstrating significant total weight loss and improvement in obesity-related comorbidities up to 2 years postoperatively. The procedure showed a favorable safety profile with low rates of serious complications.
Background
Patients with BMI ≥ 50 kg/m2 present unique challenges due to their need for greater weight loss and higher perioperative risk. Various bariatric procedures exist, but no consensus on the optimal approach has been established. Augmentation of the gastric pouch in RYGB with a silicone ring has shown improved long-term weight loss outcomes. This study specifically investigates the effectiveness and safety of the MiniMizer ring in this high-BMI population.
Data Highlights
Timepoint
% Total Weight Loss (TWL)
Median BMI (kg/m2)
% Diabetes Mellitus
% Hypertension
% OSAS
% Dyslipidemia
Baseline
0
54 (median)
14%
35%
21%
8%
3 months
16% (±5.2)
Not reported
Not reported
Not reported
Not reported
Not reported
6 months
25% (±6.0)
Not reported
Not reported
Not reported
Not reported
Not reported
1 year
32.1% (±7.4)
35.7 (IQR 31.8–39.0)
3.8%
22%
8%
8%
2 years
35% (±8.9)
34.0 (IQR 30.0–38.4)
3%
18%
9%
5%
Key Findings
Mean total weight loss reached 35% (±8.9) at 2 years post raRYGB with MiniMizer ring.
Median BMI decreased from 54 kg/m2 at baseline to 34.0 kg/m2 at 2 years.
Significant reductions in obesity-related comorbidities: diabetes mellitus decreased from 14% to 3%, hypertension from 35% to 18%, and OSAS from 21% to 9% at 2 years.
Dyslipidemia prevalence showed a modest decrease from 8% to 5% at 2 years.
Preoperative weight loss averaged 8.6 kg, potentially optimizing surgical outcomes.
The MiniMizer ring was predominantly positioned at 7.0 cm in females and 7.5 cm in males, with a median operation time of 63 minutes.
Clinical Implications
Ring-augmented RYGB with the MiniMizer ring is an effective surgical option for patients with BMI ≥ 50 kg/m2, achieving substantial weight loss and significant improvement in key obesity-related comorbidities. The procedure demonstrates a manageable safety profile and may be considered in centers with experienced bariatric surgeons. Preoperative weight loss and appropriate ring sizing are important factors to optimize outcomes.
Conclusion
The use of a MiniMizer ring in raRYGB for patients with BMI ≥ 50 kg/m2 results in significant and sustained weight loss along with marked improvements in diabetes, hypertension, and sleep apnea, supporting its role as a safe and effective bariatric surgical approach in this high-risk population.
References
IFSO Criteria for Bariatric Surgery Eligibility
ASMBS Criteria for Improvement in Obesity-Related Complications
A four-factor staging system stratified response rates from 90.9% to 37.5% in a retrospective cohort study, although the model showed only moderate discrimination (C statistic, 0.68) and requires external validation
