Causes and outcomes of revisional bariatric surgery: initial experience at a single center

Abstract

PurposeBariatric surgery has become more prevalent owing to the worldwide obesity epidemic. With the growing number of bariatric procedures performed annually, the requirement for revisional and secondary operations is increasing accordingly. This study aimed to evaluate the initial experience of revisional bariatric surgery at a single specialized center.MethodsA retrospective review of the prospectively established database identified all patients who underwent revisional bariatric surgery between January 2008 and August 2013. The causes, surgical outcomes, and efficacy of the revisional surgeries were analyzed.ResultsTwenty-two revisional surgeries were performed laparoscopically during the study period (13 laparoscopic adjustable gastric banding, 9 laparoscopic sleeve gastrectomy). The most common indication for revision was weight regain or insufficient weight loss (12/23, 52.2%), and Roux-en-Y gastric bypass (RYGB) was the most commonly performed secondary procedure (17/23, 73.9%, including four resectional RYGB procedures). Gastric pouch leak occurred in one patient following revisional RYGB, which required reoperation on the first postoperative day. The mean body mass index decreased from 35.9 to 28.8 kg/m2 at a mean follow-up period of 10 months after revision. The percent excess weight losses at 1, 3, 6, and 12 months postoperatively were 18.8%, 41.1%, 40.1%, and 47.4%, respectively.ConclusionRevisional bariatric surgery can be successfully performed via a laparoscopic approach with acceptable risk. Deliberate selection for the proper revisional procedure can efficiently manage undesirable results from the primary surgery.

Decreasing complication rates for one-stage conversion band to laparoscopic sleeve gastrectomy: A retrospective cohort study

“…[ 10 15 ] Revision procedures are generally associated with a higher risk of post-operative complications compared to primary procedures, and the perioperative morbidity rate is reportedly higher from 19% to 50%. [ 16 ] Our goal was to stress the importance of selection criteria, in order to perform the sleeve gastrectomy as a single-stage procedure along with the removal of the band and have a safe outcome. Few studies have focused exclusively on gastric band removal combined with the sleeve gastrectomy as a single procedure, whereas many articles compare the results of laparoscopic Roux-en-Y gastric bypass (RYGB) and LSG after band removal.…”

Impact of bariatric surgery on body image satisfaction among patients attending King Saud medical city

“…Obesity is considered as one of the major global epidemic problems recently; this issue leads to increasing the rate of bariatric surgery (1) . Bariatric surgery is a procedure that leads to long term weight loss (2) .…”

Reduction in Medication Use for Postrobot-Assisted Roux-en-Y Gastric Bypass as a Revisional Bariatric Procedure

“…9 Revisional surgery is indicated mainly due to insufficient weight loss after the primary bariatric procedure, persistence or recurrence of comorbidities, or complications from the index procedure. 10 Weight loss after bariatric surgery has been correlated with an improvement in medical comorbidities. 11 Recently, there has been an increased interest in targeting medical comorbidities associated with obesity as an additional indication for pursuing revisional bariatric surgery.…”