Inclusion Criteria:  Patient who has benefited from a pluridisciplinary evaluation, with a favorable opinion 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 insufficient weight 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 for Helicobacter 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 consent form 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 months previously 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 interests with the present study Patient incarcerated