**1. Introduction**

Obesity rates continue to increase globally, as well as the number of bariatric surgeries done. The RYGB is considered the gold standard bariatric surgery due to its satisfactory weight loss and remission of T2DM and other morbidities. However, the technical complexity and its long-term complications have led to a decrease in popularity over SG, which is easier to do with also satisfactory outcomes in weight loss and resolution of morbidities. However, SG also has its own shortcomings such as long-term weight regains and recurrence of co-morbidities. In an attempt to improve outcomes and decrease complications, new procedures are developed. Supplementing an intestinal bypass to an SG results in a simpler technique that has the physiologic advantages of RYGB but minimized adverse effects. The term for such procedures was coined as "sleeve-plus" by Dr. Chih-Kun Huang in the Taiwan Surgical Society of Gastroenterology meeting on October 24, 2015 [1]. As there have been several types of sleeve-plus techniques, this chapter will give a more comprehensive discussion on sleeve-plus procedures more commonly done in the Asia-Pacific region: the duodenojejunal bypass (DJB) and the proximal jejunal bypass (PJB).
