Comparative endoscopic ultrasound assessment of the gastric pouch after FundoRing-OAGB and OAGB
Ospanov O. Yelembayev B. Buchwald J.N. Sultanov K. Rakhmetov M. Duysenov G. Tuleuov B.
December 2026BioMed Central Ltd
BMC Surgery
2026#26Issue 1
Background: The highly effective one-anastomosis gastric bypass (OAGB) is one of the most widely performed procedures in bariatric/metabolic surgery. However, concerns remain regarding the association of OAGB with bile reflux and long-term weight regain. The FundoRing modification of OAGB (FundoRing-OAGB) incorporates the excluded stomach in a primary fundoplication designed to limit reflux and weight regain by exerting an anti-dilatation effect on the gastric pouch. Patients and methods: This comparative prospective post-hoc sub-study included 50 patients (25 per group) randomly selected from participants in a precursor randomized controlled trial (RCT). The sub-study aimed to assess and compare the anatomical integrity and volumetric parameters of the gastric pouch at 1 and 3 years using endoscopic ultrasound (EUS) in patients who had undergone OAGB with, or without, the FundoRing modification. Measurements included pouch diameter, volume, and wall thickness. Results: At 3 years, patients in the FundoRing-OAGB group (n = 21) had significantly lower pouch diameters (2.8 ± 0.23 cm vs. 3.41 ± 0.4 cm, p = 0.014) and volumes (60.39 ± 10.04 mL vs. 87.93 ± 25.79 mL, p < 0.001) compared to the OAGB group (n = 20). In the FundoRing-OAGB group, at year 3, pouch volume had increased 36.25% vs. an increase of 74.33% in the OAGB group (p < 0.001). Wall thickness and pouch length did not differ significantly. Conclusion: The FundoRing-OAGB modification exerted a significant anti-dilatation effect on the gastric pouch, as confirmed reliably by EUS. This effect may potentially correlate with better long-term weight maintenance; however, these clinical outcomes were not assessed in the present study. Large studies with long-term follow-up are needed to validate these findings and assess their clinical impact. Trial registration: Sub-study of#NCT04834635; registered 8 April 2021
Banded gastric bypass , Bariatric/metabolic surgery , BMS , Endoscopic ultrasound , Fundoplication , FundoRing , Gastric pouch , OAGB , One-anastomosis gastric bypass
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Department of Surgical Disease and Bariatric Surgery, Astana Medical University, Mangilik el 72 n.p.4, Astana, 010017, Kazakhstan
Surgery Center of Professor Oral Ospanov, Astana, Kazakhstan
Division of Scientific Research Writing, Medwrite Medical Communications, Maiden Rock, WI, United States
The Medical Centre Hospital of the President’s Affairs Administration of the Republic of Kazakhstan, Astana, Kazakhstan
Emergency Hospital of the Health Care Department of the Abay Region, Semey, Kazakhstan
Department of Surgical Disease and Bariatric Surgery
Surgery Center of Professor Oral Ospanov
Division of Scientific Research Writing
The Medical Centre Hospital of the President’s Affairs Administration of the Republic of Kazakhstan
Emergency Hospital of the Health Care Department of the Abay Region
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