Ring-Augmented versus Non-Ring-Augmented One-Anastomosis Gastric Bypass as Revisional Surgery after Sleeve Gastrectomy: a Comparative Cohort Study Ahmed Elmasry, Mohamed Sallam, Mahmoud F. Abdelaziz, Amr Abdelatyy, Mohamed Abdelgawad, et al. Obesity Surgery, 2026 Background Sleeve gastrectomy (SG) is the most frequently performed metabolic and bariatric surgery (MBS) worldwide, but long-term suboptimal weight loss (SOWL) or recurrent weight gain (RWG) affects up to one third of patients and often necessitates revisional procedures. One-anastomosis gastric bypass (OAGB) is an effective revision, yet pouch dilation and late RWG remain concerns. Ring augmentation (RA) has been proposed to enhance restriction and sustain weight loss, but evidence in the revisional OAGB setting is limited. Methods This retrospective comparative cohort study analyzed 94 adults who underwent revisional OAGB after SG at a high-volume tertiary MBS center. Patients were grouped into two categories: Ring Augmented OAGB (RaOAGB) ( n = 45) and Non-Ring Augmented OAGB (NRa-OAGB) ( n = 49). The primary outcomes were percentage excess weight loss (%EWL), percentage total weight loss (%TWL), and change in body mass index (BMI) at 3, 6, and 12 months. Secondary outcomes included improvement of obesity-related conditions, metabolic parameters (lipid profile, HbA1c), nutritional markers, operative time, hospital stay, and early/late complications. Results Both groups achieved significant weight reduction at 12 months ( p < 0.001 within groups). RaOAGB yielded greater BMI reduction (27.6 vs. 32.2 kg/m²), %EWL (81.7% vs. 61.3%), and %TWL (31.5% vs. 24.2%) compared with NRa-OAGB (all p < 0.001). Lipid profiles improved in both groups; LDL decreased, and total cholesterol equalized by 12 months. Glycemic control changes were modest and similar between cohorts. Operative time, length of stay, and early postoperative complications were comparable. Ring-related adverse events were infrequent (food intolerance 6.7% vs. 4.1%; no erosions were observed; one patient (2.2%) required ring removal at 10 months due to persistent vomiting and food intolerance). Conclusions RaOAGB is a safe and effective revisional option for RWG and SOWL after SG, achieving significantly greater 1-year weight loss than standard OAGB, with uncommon ring-related adverse events, including one ring removal. These findings support the role of mechanical reinforcement to enhance the durability of revisional bypass but warrant confirmation through long-term, multicenter randomized trials.
Ring-Augmented Versus Non-Ring Augmented Sleeve Gastrectomy in Patients with BMI > 50 kg/m²: 3-Year Follow-up of a Randomized Controlled Trial Mohamed Hany, Walid El Ansari, Mohamed H. Zidan, Anwar Ashraf Abouelnasr, Mohamed Ibrahim, et al. Obesity Surgery, 2026 Background Sleeve gastrectomy (SG) is effective but prone to late recurrent weight gain (RWG). Ring-augmented SG (Ra-SG) may preserve restriction and enhance long-term durability. Methods In this single-center, prospective, single-blind randomized trial, adults with a BMI > 50 kg/m² were randomized to SG or Ra-SG and followed for 36 months. The primary endpoint was percent total weight loss (%TWL) at 36 months. Secondary outcomes included RWG, gastric pouch volumetry, relapse of associated medical problems, complications, endoscopic findings, laboratory parameters, and patient-reported outcomes (SF-36, Suter). Results Ra-SG produced significantly greater weight loss at 36 months (48.8 ± 8.3 vs. 45.5 ± 9.0%TWL; mean difference 3.25% points, 95% CI 0.86 to 5.63; p 0.008). Exploratory analyses showed lower rates of clinically significant RWG (≥ 30% regain: 5.9% vs. 16.3%; absolute risk difference − 10.4%, 95% CI − 19.6 to − 1.2; p = 0.033) and smaller pouch volumes (160.1 ± 8.9 vs. 194.2 ± 10.3 mL; p < 0.001). Perioperative complications were infrequent and comparable. At three years, the prevalence of endoscopic GERD was similar (17.3% vs. 19.6%). Food tolerance scores were consistently better after SG (all p < 0.05). HRQoL improved significantly in both groups, with no differences observed at 36 months. Two Ra-SG patients (1.8%) underwent ring removal. Conclusions Ra-SG enhanced weight-loss durability and lowered RWG compared to SG, with similar safety and GERD outcomes but decreased food tolerance at mid-term. Ra-SG may be considered in patients at higher risk of RWG, though multicenter studies with longer follow-up are needed to confirm these findings.
Effect of Roux-en-Y Gastric Bypass and Sleeve Gastrectomy on Male Sexual Function: A Systematic Review and Meta-Analysis Mohamed Hany, Mohamed H. Zidan, Hashem Altabbaa, Ahmed El Shamarka, Marwan Emad Abdou, et al. Obesity Reviews, 2026 Background Obesity negatively impacts male sexual function and fertility through hormonal imbalances, endothelial dysfunction, and psychosocial factors. Metabolic and bariatric surgery (MBS) constitutes an effective intervention; however, procedure‐stratified changes in male reproductive parameters after Roux‐en‐Y gastric bypass (RYGB) and sleeve gastrectomy (SG) remain incompletely synthesized. Methodology A systematic search of PubMed, Embase, Cochrane Library, Scopus, and Web of Science was conducted in November 2024. Sexual function, testosterone levels, and semen quality were included. Risk of bias was assessed using MINORS criteria. Random‐effects meta‐analyses were performed separately for each surgical modality, with heterogeneity quantified via I 2 statistics. Results Twenty‐one studies comprising 848 patients were included. Meta‐analysis of pre–post data demonstrated that both RYGB and SG were independently associated with improvements in sex hormone–binding globulin and testosterone levels. In studies examining SG, significant improvements were observed in erectile function (SMD: 1.38, 95% CI: 0.66–2.10, p = 0.0002) and sperm concentration (SMD: 0.91, 95% CI: 0.56–1.26, p < 0.00001). Studies evaluating RYGB did not demonstrate statistically significant changes in erectile function (SMD: 0.62, 95% CI: −0.06 to 1.30, p = 0.07) or sperm concentration (SMD: −0.01, 95% CI: −0.45 to 0.42, p = 0.95). Conclusion The meta‐analytical findings suggest beneficial effects of both RYGB and SG on male hormonal parameters. Studies of SG demonstrated significant improvements in erectile function and sperm concentration. However, direct comparative analyses between the two procedures were not performed, precluding definitive conclusions regarding their relative efficacy. Future research necessitates head‐to‐head comparisons with standardized reproductive endpoints and extended follow‐up periods.
GIST in perforated Meckel's diverticulum Mohamed H. Zidan, Yasmin Hassan, Mohamed Sabry, Marwan Emad, Hashem Altabbaa, et al. Surgery Open Digestive Advance, 2023
First Documented Case of a Mesenteric Cyst Incarcerated Within a Primary Paraumbilical Ventral Hernia: A Case Report and Focused Review of the Literature A Amgad, M Emad, H Altabbaa, M Al Sayed, MH Zidan SN Comprehensive Clinical Medicine 8 (1), 98 , 2026 2026
Global Technical Variations in Roux-en-Y Gastric Bypass: A Worldwide Survey Among IFSO Members M Hany, MH Zidan, H Altabbaa, A Amgad, H Al-Momani, A Mosaad, ... Obesity Surgery, 1-23 , 2026 2026
Excluded-stomach Perforation after Roux-en-Y and One-anastomosis Gastric Bypass: A Systematic Review with Video-illustrated Case Report M Hany, A Wafa, MS Youssef, MH Zidan, H Altabbaa, H Al-Momani, ... Obesity Surgery, 1-14 , 2026 2026
Publisher Correction: Ring-Augmented versus Non-Ring-Augmented One-Anastomosis Gastric Bypass as Revisional Surgery after Sleeve Gastrectomy: a Comparative Cohort Study A Elmasry, M Sallam, MF Abdelaziz, A Abdelatyy, M Abdelgawad, ... Obesity surgery , 2026 2026
One Anastomosis Gastric Bypass with Remnant Stomach Resection for an Undiagnosed Gastric Lesion: A Case Report H El-Masry, M Al Sayed, A Selim, A AboKhozima, AA Elmagd, M Alokl, ... SN Comprehensive Clinical Medicine 8 (1), 147 , 2026 2026
Ring-Augmented versus Non-Ring-Augmented One-Anastomosis Gastric Bypass as Revisional Surgery after Sleeve Gastrectomy: a Comparative Cohort Study A Elmasry, M Sallam, MF Abdelaziz, A Abdelatyy, M Abdelgawad, ... Obesity Surgery, 1-13 , 2026 2026
Short-term outcomes of robotic versus laparoscopic TAPP for inguinal hernia repair: a systematic review, meta-analysis, and GRADE assessment MH Zidan, M AlSayed, M Maged, H Altabbaa, AM Hadhoud, MA Hussein, ... Journal of Robotic Surgery 20 (1), 419 , 2026 2026
Accuracy and Knowledge Base Evaluation of ChatGPT-4o, Gemini-2.0-Flash, and DeepSeek-V3 in Metabolic and Bariatric Surgery: an Expert-Rated Blinded Study M Hany, MH Zidan, C Parmar, SS Shahmiri, H Altabbaa, A El-Shamarka, ... Obesity Surgery, 1-12 , 2026 2026
The Impact of Laparoscopic Sleeve Gastrectomy on Upper Airway Function and Sleep-disordered Breathing J Mekky, M Zidan, MS Elhadedy, H Garraf, AA Aboulnasr, MM Elshafei, ... Sleep Medicine 138, 108238 , 2026 2026
From body mass index to biology: reconciling diagnostic clarity and surgical eligibility in obesity care M Hany, MH Zidan, A El Shamarka, RV Cohen Obesity Surgery 36 (2), 786-791 , 2026 2026 Citations: 2
Ring-Augmented Versus Non-Ring Augmented Sleeve Gastrectomy in Patients with BMI> 50 kg/m²: 3-Year Follow-up of a Randomized Controlled Trial M Hany, W El Ansari, MH Zidan, AA Abouelnasr, M Ibrahim, H Al Momani, ... Obesity Surgery, 1-19 , 2026 2026 Citations: 1
Effect of Roux‐en‐Y Gastric Bypass and Sleeve Gastrectomy on Male Sexual Function: A Systematic Review and Meta‐Analysis M Hany, MH Zidan, H Altabbaa, A El Shamarka, ME Abdou, M Al Sayed, ... Obesity Reviews, e70136 , 2026 2026
Comments on the Study “Long-Term Outcomes in Sleeve Gastrectomy versus Roux-en-Y Gastric Bypass: A Systematic Review and Meta-Analysis of Randomized Trials”: Methodological … MH Zidan, M Hany Obesity Surgery 36 (1), 367-368 , 2026 2026
Global variation in emergency colorectal cancer surgery: Results from the APOLLO prospective cohort study in 39 countries ES Collaborative, S Collaborative Surgery, 109964 , 2025 2025
Acute presentations of colorectal cancer: an international prospective snapshot on management and outcomes EuroSurg Collaborative, STARSurg Collaborative World Journal of Surgery 49 (12), 3368-3377 , 2025 2025 Citations: 4
Re: Comments on Article “Fixation of the Esophagus to Diaphragmatic Hiatus as a Routine Step in Hiatal Hernia Repair During Bariatric Surgery: How to Do It?” M Hany, MH Zidan Obesity Surgery 35 (12), 5641-5642 , 2025 2025
Anatomical Remodeling of the Upper Airway after Laparoscopic Sleeve Gastrectomy: A Multimodal Assessment of Structural and Functional Improvements in Obstructive Sleep Apnea M Hany, MH Zidan, MS Elhadidy, AA Abouelnasr, MM El Shafei, ... Obesity Surgery, 1-20 , 2025 2025 Citations: 1
From Primum Non Nocere to Primum Succurrere: Reframing Surgical Ethics in Metabolic and Bariatric Surgery M Hany, MH Zidan, RV Cohen Obesity Surgery 35 (10), 4032-4037 , 2025 2025
Evaluating Early Asymptomatic Postoperative Sinus Bradycardia Following Sleeve Gastrectomy: A Preliminary Observational Study A Abokhozima, H El-Masry, MH Zidan, AA Elmagd, H Altabbaa, ... Obesity Surgery 35 (9), 3970-3976 , 2025 2025
Conversion of a Failed Vertical Banded Gastroplasty to One-Anastomosis Gastric Bypass in a Case with Gastro-gastric Fistula and Mesh Complication: A Multimedia Article M Hany, MH Zidan, MS Youssef, AA Abouelnasr, N Zayed, M Ibrahim, ... Obesity Surgery 35 (9), 3953-3957 , 2025 2025 Citations: 1
MOST CITED SCHOLAR PUBLICATIONS
Determinants of morbidity and mortality following emergency abdominal surgery in children in low-income and middle-income countries AO Ademuyiwa, AP Arnaud, TM Drake, JEF Fitzgerald, D Poenaru, ... BMJ global health 1 (4) , 2016 2016 Citations: 106
Post-cholecystectomy bile duct injuries: a retrospective cohort study MHED Zidan, M Seif-Eldeen, AA Ghazal, M Refaie BMC surgery 24 (1), 8 , 2024 2024 Citations: 34
Evaluation of laparoscopy virtual reality training on the improvement of trainees’ surgical skills M Elessawy, M Mabrouk, T Heilmann, M Weigel, M Zidan, ... Medicina 57 (2), 130 , 2021 2021 Citations: 31
Can incidental gastric GISTs during bariatric surgeries change the primary plan of surgery? A single team experience and a systematic review of literature A Abokhozima, MH Zidan, H Altabbaa, A Abo Elmagd, M Alokl, F Fathy, ... Obesity Surgery 34 (6), 2186-2197 , 2024 2024 Citations: 19
Trends and practices in bariatric surgery in Egypt: insights on esophagogastroduodenoscopy (EGD) utilization and surgical volumes MH Zidan, A Abokhozima, MIA Gaber, A Amgad, H Altabbaa, H El-Masry, ... Obesity Surgery 35 (7), 2528-2548 , 2025 2025 Citations: 16
Advancements in bariatric surgery: a novel parametric classification of metabolic and bariatric procedures MH Zidan, A Amgad, M Al Sayed, H Altabbaa, H El-Masry, A Bessa, ... Obesity Surgery 35 (1), 4-6 , 2025 2025 Citations: 12
Bridging generations in metabolic and bariatric surgery: honoring legacy and embracing technology in the age of artificial intelligence M Hany, ME Abdou, A Abokhozima, MH Zidan Obesity Surgery 35 (2), 376-378 , 2025 2025 Citations: 11
The impact of weight loss after bariatric surgeries on the patient’s body image, quality of life, and self-esteem A AboKhozima, MH Zidan, H Altabbaa, A Selim, M Alokl, M Mourad, ... Langenbeck's Archives of Surgery 410 (1), 24 , 2025 2025 Citations: 8
A case of giant inguinoscrotal hernia managed by preoperative pneumoperitoneum with an unforeseen complication and outcome: a case report and review of literature AH El Shamarka, MH Zidan, MS Youssef, AH El Banna, M Mourad Hernia 27 (6), 1611-1615 , 2023 2023 Citations: 8
Port site placement and outcomes for surgical obesity and metabolic surgeries (PSPOSO) checklist: A new reporting checklist based on evidential assessment of the number of … MH Zidan, H El-Masry, A Amgad, H Altabbaa, ME Abdou, SA Amer, ... Obesity Surgery 35 (3), 1086-1108 , 2025 2025 Citations: 7
A successful central gastrectomy and gastro-gastric anastomosis for a large gastric GIST M Zidan, E Hassan, M Refaie Journal of Gastrointestinal Cancer 55 (1), 202-206 , 2024 2024 Citations: 5
Acute presentations of colorectal cancer: an international prospective snapshot on management and outcomes EuroSurg Collaborative, STARSurg Collaborative World Journal of Surgery 49 (12), 3368-3377 , 2025 2025 Citations: 4
The utilization of Bloom’s taxonomy in bariatric surgery training: A comprehensive approach to mastery in surgery A Abokhozima, H El-Masry, M Hany, MH Zidan Obesity Surgery 35 (2), 383-386 , 2025 2025 Citations: 4
Should incidentally discovered Meckel’s diverticulum during bariatric procedures be resected? Raising a hypothesis for future research MH Zidan, M Al Sayed, H El-Masry, H Altabbaa, A Selim, M Alokl, ... Obesity Surgery 34 (12), 4309-4311 , 2024 2024 Citations: 4
GIST in perforated Meckel's diverticulum MH Zidan, Y Hassan, M Sabry, M Emad, H Altabbaa, M Mourad Surgery Open Digestive Advance 12, 100115 , 2023 2023 Citations: 4
Young-IFSO endoscopy training and education survey DM Felsenreich, AC Batista Dantas, S Shahabi, TN Abdelbaki, R Zakeri, ... Obesity Surgery 35 (7), 2498-2505 , 2025 2025 Citations: 3
Neglecting evidence and systematic review protocols while oversimplifying management: a critical appraisal of incidental GISTs in patients undergoing bariatric surgery MH Zidan, H El-Masry, AA Elmagd, M Alokl, A Abokhozima Obesity Surgery 35 (3), 1199-1200 , 2025 2025 Citations: 3
Nutritional concerns in the meta-analysis comparing SADI and OAGB as revisional procedures following sleeve gastrectomy H El-Masry, MH Zidan, M Hany, A Abokhozima Obesity Surgery 35 (3), 1178-1181 , 2025 2025 Citations: 3
Medical malpractice stress syndrome in bariatric surgery: navigating ethical challenges and patient perceptions MH Zidan, A Abokhozima, HASM Hussein, M Hany Obesity Surgery 35 (1), 1-3 , 2025 2025 Citations: 3
From body mass index to biology: reconciling diagnostic clarity and surgical eligibility in obesity care M Hany, MH Zidan, A El Shamarka, RV Cohen Obesity Surgery 36 (2), 786-791 , 2026 2026 Citations: 2