Bmi 46 Kg/m² Has in Surgery — 23yo Man | General Surgery | SMLE Q#11150

SMLE Question #11150

Surgery General Surgery

Objective: OBJ-TRACH-EMERG-01

Last updated: February 2026
A 23-year-old man with BMI 46 kg/m² has 5 years of heartburn, nocturnal regurgitation, and intermittent dysphagia despite maximal proton pump inhibitor therapy and lifestyle measures. Upper GI endoscopy shows a large sliding hiatal hernia with Los Angeles grade C erosive esophagitis. He requests a bariatric operation that is most likely to improve reflux while achieving durable weight loss. Which weight-reduction procedure is most appropriate?

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