Sleeve Gastrectomy With Transit Bipartition(SG+TB) Versus Roux-en-Y Gastric Bypass (RYGB) for Type 3 Obesity

Inclusion Criteria:

• Patient who has benefited from a pluridisciplinary evaluation, with a favorableopinion for SG+TB or RYGB as a first intention procedure with BMI ≥40 kg/m2 or BMI ≥ 35 kg/m2 associated with one co-morbidity which will be improved by surgery (according to HAS 2009 recommendation3) OR as a second intention procedure (revisional surgery) after failure of Sleeve gastrectomy (defined as insufficientweight loss at 18 months after surgery (EWL% <50), or as weight regain (+ 20%)).

• Patient who had benefited from an Upper GI Endoscopy with biopsies to look forHelicobacter Pylori (HP) and a HP eradication.

• Patient who understands and accepts the need for a long-term follow-up

• Patient who agrees to be included in the study and who signs the informed consentform

• Patient affiliated to a healthcare insurance plan

Exclusion Criteria:

• History of previous bariatric surgery, other than a Sleeve Gastrectomy

• Patient with current BMI > 60 kg/m2

• Presence of a severe and evolutive life threatening pathology, unrelated to obesity

• History of Chronic inflammatory bowel disease

• Type 1 Diabetes

• Pregnancy or desire to be pregnant during the study

• Nursing woman

• Presence of Pylori Helicobacter resistant to medical treatment

• Presence of a non-healed gastro-duodenal ulcer or diagnosed less than 2 monthspreviously

• Severe esophagitis (grade C of Los Angeles classification)

• Hiatal hernia

• Patients with unstable psychiatric disorder, under supervision or guardianship

• Patient who does not understand French/ is unable to give consent

• Patient not affiliated to a French or European healthcare insurance

• Patient who has already been included in a trial which has a conflict of interestswith the present study

• Patient incarcerated