Can a new stomach and gut bypass surgery tackle obesity and diabetes?

Copied word for word from the study's registry entry, so the wording is the study team's rather than ours.

Inclusion Criteria * Age 18-65 years. * Body mass index (BMI) ≥35 kg/m², regardless of the presence or severity of obesity-associated medical conditions; or BMI 30.0-34.9 kg/m² with type 2 diabetes mellitus or another clinically significant obesity-associated medical condition and inadequate weight loss or improvement following appropriate nonsurgical management. * Eligible for metabolic and bariatric surgery following multidisciplinary clinical assessment. * Considered suitable for laparoscopic Stapled Intact-Duodenum Bipartition with Sleeve Gastrectomy (SIBS) based on preoperative assessment. * For primary procedures, no previous metabolic or bariatric surgical procedure. * For revisional procedures, previous sleeve gastrectomy with a clinical indication for revisional metabolic/bariatric surgery and anatomy considered suitable for SIBS. * Able to understand the investigational nature of the SIBS procedure, its potential risks and benefits, and established alternative bariatric procedures. * Able and willing to provide written informed consent. * Willing and able to comply with the scheduled postoperative clinical, nutritional, laboratory, and study follow-up for at least 12 months. Exclusion Criteria * Age \<18 years or \>65 years. * Pregnancy or breastfeeding. * Planned pregnancy during the 12-month postoperative study period. * Contraindication to general anesthesia or laparoscopic metabolic/bariatric surgery. * Previous gastrointestinal surgery resulting in anatomy that precludes safe performance of the planned SIBS procedure, except previous sleeve gastrectomy in participants undergoing an eligible revisional procedure. * Intraoperative anatomy that prevents safe creation of a tension-free side-to-side duodenoileal anastomosis. * Active inflammatory bowel disease involving the small intestine. * Active gastrointestinal malignancy or other active malignancy for which the proposed operation or follow-up would be inappropriate. * Severe hepatic dysfunction, severe renal dysfunction, or another major systemic illness considered to confer an unacceptable operative or nutritional risk. * Pre-existing severe protein-calorie malnutrition or clinically significant nutritional deficiency that cannot be adequately corrected before surgery. * Active gastrointestinal ulceration or another gastrointestinal condition considered to substantially increase the risk of the planned procedure. * Uncontrolled psychiatric illness or cognitive impairment that precludes valid informed consent or adherence to postoperative care. * Active alcohol or substance use disorder considered incompatible with safe metabolic and bariatric surgery. * Inability or unwillingness to adhere to postoperative dietary recommendations, nutritional supplementation, or scheduled follow-up. * Any medical, surgical, anatomical, or psychosocial condition that, in the judgment of the multidisciplinary bariatric team, makes participation or performance of SIBS inappropriate or unsafe.