Fig. 1: Conceptual representation of the different bariatric procedures.

These are classic Roux-en-Y gastric bypass (C-RYGB, A), metabolic Roux-en-Y gastric bypass (M-RYGB, B), single-anastomosis duodeno-ileal bypass with sleeve gastrectomy (SADI-S, C) and biliopancreatic diversion with duodenal switch (BPD-DS, D). In pink, the gastric pouches (C-RYGB (A) and M-RYGB (B)), gastric sleeves (SADI-S (C) and BPD-DS (D)) and the alimentary limbs (AL), which in C-RYGB (A) and M-RYGB (B) measure 120 cm and in BPD-DS (D) measure 200 cm. In green, the biliopancreatic limbs (BPL) which are formed with the initial portion of the jejuno-ileum. The BPL measures 50–100 cm in C-RYGB (A), 200 cm in M-RYGB (B) and variable lengths in SADI-S (C) and BPD-DS (D). Lastly, in purple, the common channel (CC), which has a variable length in C-RYGB (A) and in M-RYGB (B) and fixed length of 300 cm in SADI-S (C) and 100 cm in BPD-DS (D).