Dear Wen Chen, Ting-Sian Yu, and Kuo-Chuan Hung,

Thank you for your insights. We would like to sincerely express our appreciation for your thoughtful feedback on our meta-analysis. Your insights have been incredibly valuable, and I want to assure you that we have taken your suggestions seriously. Please find below your responses.

Dealing with Heterogeneity

We understand that there is significant variability in certain aspects of our study, especially in gastroesophageal reflux disease (GORD) and reoperation rates after sleeve gastrectomy with HHR. In hindsight, we agree a random-effects model would be more appropriate and we will keep in mind regarding future analysis and additional analysis related to this work.

Considering Generalizability

We noted your point also about the wide prediction interval potentially affecting how broadly our findings can be applied. We are keen to explore this in any subsequent work relating to this work. In the meantime, we agree with your cautions regarding interpretation of this meta-analysis due to the heterogeneity and wide prediction intervals. We believe your letter and additional analysis that you have conducted as depicted in Figure 1 has highlighted your points very clearly.

Being Transparent in Reporting

We are committed to being upfront about any limitations or uncertainties tied to our findings. Transparency is key, and we want readers to have a clear understanding of our study’s nuances.

Your expertise and this letter have been crucial in refining our work and highlighting limitations to our analysis. We are open to any additional suggestions or specific areas you think we should focus on for future publication.

Iskandar Idris (on behalf of authors)