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Stier et al. Mini-invasive Surg 2020;4:18 I http://dx.doi.org/10.20517/2574-1225.2019.75 Page 7 of 11

Figure 4. Banded bypass

Figure 5. Roux-en-Y gastric bypass with minimiser

demonstrate that SG volume plays a decisive role in weight management (initial weight loss, weight loss
failure and possible weight regain). Weight regain is the most feared concern not only in bariatric patients.
Actually, SG is globally the most applied bariatric procedure and weight regain occurs frequently after
this procedure. 3D volumetry might be a new focus of diagnostic interest for two reasons. Firstly, it shows
a rotatable 3D model of the stomach and its attached structures, even under the most difficult anatomical
conditions. In addition, it allows a precise and highly reproducible evaluation of volume alterations of the
stomach.

3D-CT is the only accurate diagnostic option available for these purposes. Different bariatric procedures
and different surgical techniques lead to varying outcomes, which present challenges pertaining to
the evaluation of post-surgical volume and gastro-intestinal (GI) anatomy, especially in regard to the
comparability of former, contemporary and future examinations. For this purpose, a protocol should be
followed that provides standardised procedural principles for all examinations, thus granting comparability
of the results. A diagnostic algorithm is shown in Figure 7.