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In patients with class V obesity, the definitive bariatric procedure is still a matter of debate. This study compared surgical procedures (SASI vs. RYGB) in people with class V obesity. The primary objective was to compare weight loss after both procedures over a 1-year follow-up. Secondary outcomes included the evaluation of the incidence of the operative time (skin-to-skin), postoperative complications, duration of hospital stay, rate of conversion to the open technique, and quality of life, as well as amelioration of obesity-related comorbidities.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Methods<\/jats:title>\n            <jats:p>From January 2019 to December 2022, the data of 73 consecutive patients with class V obesity was collected, who underwent either standard RYGB (<jats:italic>n<\/jats:italic>\u2009=\u200940) or SASI (<jats:italic>n<\/jats:italic>\u2009=\u200933) at the General Surgery Department of Alexandria University Hospital and some non-governmental hospitals.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results<\/jats:title>\n            <jats:p>There was no statistically significant difference between both groups as regards mean age (p\u2009=\u20090.012), sex (<jats:italic>p<\/jats:italic>\u2009=\u20090.250), preoperative BMI (<jats:italic>p<\/jats:italic>\u2009=\u20090.754), or preoperative incidence of obesity-related co-morbidities. The SASI procedure showed a statistically shorter operative time (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001). There was no significant difference between the two groups as regards the incidence of postoperative surgical complications, either early cmplications (21.1% and 20% in both SASI and RYGB, respectively, <jats:italic>p<\/jats:italic>\u2009=\u20090.770) or late (beyond 30\u00a0days) complications (15.2% and 15% in SASI and RYGB, respectively, <jats:italic>p<\/jats:italic>\u2009=\u20091.000), with neither conversion nor intra-operative mortality in both groups. However, the SASI group showed a significant shorter postoperative hospital stay (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001). During the follow-up period, both operations demonstrated a significant overall resolution of pre-operative obesity-related comorbidities, a significant increase in postprandial 6\u00a0weeks postoperative GLP-1 with statistically more rise in the SASI group in the postprandial GLP-1 compared to the RYGB group (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001). There was no mortalities in both group during the follow up duration.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusion<\/jats:title>\n            <jats:p>In patients with class V obesity, the SASI procedure had a statistically shorter operative time (skin-to-skin) and a shorter hospital stay compared to RYGB. Both procedures resulted in satisfactory weight loss, as well as comparable improvements in obesity-related comorbidities.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1007\/s11695-025-07930-5","type":"journal-article","created":{"date-parts":[[2025,5,28]],"date-time":"2025-05-28T02:23:25Z","timestamp":1748399005000},"page":"2446-2460","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Laparoscopic Single Anastomosis Sleeve Ileal Bypass Versus Laparoscopic Roux-en-Y Gastric Bypass as Single Stage Procedure for Management of Patients with Class V Obesity (BMI \u2265\u200960 kg\/m2): Short-Term Follow-Up"],"prefix":"10.1007","volume":"35","author":[{"given":"Mohamed","family":"Wael","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohamed Mosaad","family":"Kandel","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hashem","family":"Altabbaa","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mostafa Refaie","family":"Elkeleny","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2025,5,28]]},"reference":[{"key":"7930_CR1","unstructured":"WHO Consultation on Obesity (1999: Geneva, Switzerland) & World Health Organization. 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