In addition to being a relatively reversible and less complex operation, mini-gastric bypass-one anastomosis gastric bypass (MGB-OAGB) has demonstrated comparable weight loss and metabolic improvement rates with Roux-en-Y gastric bypass (RYGB). However, surgical strategies for managing its failures and late complications were poorly defined. This article aims to review the indications, operative techniques, and outcomes for revisional surgery following MGB-OAGB. A systematic review was performed using the PubMed database from 1997 to 2019. Of 179 included patients, 89 underwent revision to RYGB; 52 to sleeve gastrectomy (SG); 32 reversal to original anatomy; and 6 underwent partial revision with gastro-gastrostomy alone. Most common indications were severe malnutrition, chronic bile reflux, intractable marginal ulcerations, and insufficient weight loss. Postoperative complication rates ranged from 5 to 35%.
Our experience demonstrates that the robotic-assisted approach to MAL release may be safe and efficacious in selected patients. Prospective comparative studies are required to further evaluate its outcomes against conventional laparoscopic approach, the current gold standard.
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