Sleeve-fundoplication without gastric resection reduces GERD incidence versus sleeve gastrectomy in obese rat model

Sleeve gastrectomy (SG) is a first-line bariatric procedure but may exacerbate gastroesophageal reflux disease (GERD) symptoms in obese patients. To mitigate this critical limitation, we developed a novel sleeve-fundoplication without gastric resection (SG-F) and investigated its efficacy and safety in a rat model of diet-induced obesity. A randomized controlled trial was conducted in twenty-four 8-week-old male SD obese rats, randomly assigned to the SG group (n = 12) or the SG-F group (n = 12). Postoperative complications (mortality, bleeding, GERD) and body weight changes were monitored for 6 weeks. The primary endpoint was the 6-week body weight change trajectory, and the secondary endpoint was postoperative GERD incidence. No statistically significant differences were observed in postoperative mortality or bleeding rates between the two groups. The incidence of postoperative GERD was significantly lower in the SG-F group than in the SG group (0% vs. 41.7%; P < 0.05; RR: 0.1, 95% CI: 0.01–0.79). A significant between-group difference in body weight was noted at 4 weeks postoperatively (SG-F: 473.4 ± 18.5 g vs. SG: 513.6 ± 21.3 g; P < 0.05; MD: −40.2 g, 95% CI: −65.1 to −15.3 g), while the overall 6-week weight loss effect was comparable between the two procedures (P = 0.307). SG-F achieves weight loss efficacy comparable to conventional SG without gastric resection, while suggesting improved anti-reflux protection and maintaining similar safety profiles in terms of mortality and bleeding. This novel procedure represents a promising alternative bariatric option for obese patients with GERD, avoiding the need for gastric tissue excision.