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The results show the benefits of both techniques, OAGB being the easiest to perform and with less surgical time.

Highlights Weight regain is a common problem within Bariatric Surgery and about 20% of patients who undergo Roux-en-Y gastric bypass patients may experience weight regain. Among the arsenal of alternatives to treat weight regain we have endoscopic therapies and surgical modifications of the primary technique, among others. This case represents the first report in which endoscopic therapy via transjejunal is used in conjunction with distalization of the biliopancreatic limb.

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Rationale: Sleeve gastrectomy is the most frequent surgery performed worldwide in bariatric surgery. In recent years, there has been an increase in the tendency to perform this procedure using a single port; however, to date, there have been no reports of this magnet-assisted surgery. We developed a magnet-assisted sleeve gastrectomy technique to demonstrate the use of magnets in different steps of the surgery to perform this procedure. Patient Concerns: A 38-year-old woman with a body mass index of 36.2 kg/m2 attended the clinic with the desire to lose weight in order to improve her living conditions. Diagnosis: Based on her weight and height, the patient's body mass index was diagnosed as obese grade II. During the examination by the multidisciplinary team, the patient presented with a blood pressure of 133/86 mm Hg and was diagnosed with hypertension. Intervention: The sleeve gastrectomy technique was performed in a standard manner using a single port located in the umbilicus and a 5-mm port in the right upper quadrant. In addition, we used a magnet positioned on the outside of the patient's abdomen, and a grasper coupled to a magnet was positioned in different parts of the cavity to assist in different steps of the surgery. Outcomes: The surgery was successfully completed with no intraoperative complications with the use of magnetic devices. The patient was discharged 36 hours postoperatively with nutritional indications. At the month follow-up the patient lost 7 kg of initial weight. Lessons: The use of a novel magnetic device can achieve a greater degree of ease in the face of difficulties associated with single-port sleeve gastrectomy.

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