Kayleigh A M van Dam, Maurizio De Luca, Matteo Monami, Evert-Jan G. Boerma, Giovanni Merola, Antonio Vitiello, Ricardo Cohen, Ashraf Haddad, Khaled Gawdat, Jodok Fink, Hayssam Fawal, Amanda Belluzzi, JAN WILLEM GREVE
In this position statement, the International Federation for the Surgery of Obesity and Metabolic Disorders (IFSO) highlights the evaluation of ring-augmented procedures in Metabolic Bariatric Surgery (MBS). A GRADE-based systematic review and meta-analysis were conducted to assess their effectiveness and safety. The analysis included 28 studies with 6939 patients. The findings demonstrated that ring augmentation in bariatric procedures may provide superior or comparable weight loss outcomes compared to standard procedures, although results were heterogenous and evidence quality varied. Ring-related complications and removal rates were generally low. While further high-quality, long-term studies are needed, current evidence cautiously supports selective use of ring augmentation in both primary and revisional MBS, particularly for Roux-en-Y Gastric Bypass (raRYGB).