Indications, safety, and feasibility of conversion of failed bariatric surgery to Roux-en-Y gastric bypass: a retrospective comparative study with primary laparoscopic Roux-en-Y gastric bypass

Deylgat, Bert; D’Hondt, Mathieu; Pottel, Hans; Vansteenkiste, Franky; Rooy, Frank Van; Devriendt, Daniel

doi:10.1007/s00464-011-2140-0

Cited by 55 publications

(25 citation statements)

References 23 publications

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“…In our experience, RYGB is the procedure of choice for revising previous bari atric surgery, specifically VBG, because of its effective weight loss results and safety. [23][24][25] Not surprisingly, patients who underwent VBG most often qualified for further surgery (23% underwent RYGB), whereas most patients who had anatomically successful operations, such as prior SG or RYGB, were unlikely to need further surgical management (92%). In these patients, we often repaired hernias and performed panniculectomies.…”

Section: Discussionmentioning

confidence: 99%

A comparison of revisional and primary bariatric surgery

Fulton

Sheppard

Birch

et al. 2017

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A comparison of revisional and primary bariatric surgeryBackground: Revisional surgery is an important component of addressing weight regain and complications following primary bariatric surgery. Owing to provincial need and the complexity of this patient population, a specialized multidisciplinary revision clinic was developed. We sought to characterize patients who undergo revision surgery and compare their outcomes with primary bariatric surgery clinic data. Methods:We completed a retrospective chart review of bariatric revision clinic patients compared with primary bariatric surgery patients from December 2009 to June 2014. Results:We reviewed the charts of 2769 primary bariatric clinic patients, 886 of whom had bariatric surgery, and 534 revision bariatric clinic patients, 83 of whom had revision surgery. Fewer revision clinic patients underwent surgery than primary clinic patients (22% v. 32%). The mean preoperative body mass index (BMI) was 44.7 ± 9.5 in revision patients compared with 45.7 ± 7.6 in primary bariatric surgery patients. Most revision patients had a prior vertical banded gastroplasty (VBG; 48%) or a laparoscopic adjustable gastric band (LAGB; 24%). Bands were removed in 36% of all LAGB patients presenting to clinic. Of the 134 procedures performed in the revision clinic, 83 were bariatric weight loss surgeries, and 51 were band removals. Revision clinic patients experienced a significant decrease in BMI (from 44.7 ± 9.5 to 33.8 ± 7.5, p < 0.001); their BMI at 12-month follow-up was similar to that of primary clinic patients (34.5 ± 7.0, p = 0.7). Complications were significantly more frequent in revision patients than primary patients (41% v. 15%, p < 0.001). Conclusion:A bariatric revision clinic manages a wide variety of complex patients distinct from those seen in a primary clinic. Operative candidates at the revision clinic are chosen based on favourable medical, anatomic and psychosocial factors, keeping in mind the resource constraints of a public health care system. Contexte : La chirurgie de révision est une intervention importante lors d'une reprise de poids ou lors de complications à la suite d'une chirurgie bariatrique primaire. Compte tenu des besoins provinciaux et de la complexité de cette population de patients, une clinique de révision multidisciplinaire spécialisée a été créée. Nous avons voulu caractériser les patients qui subissent une chirurgie de révision et comparer leurs résultats aux données de la clinique de chirurgie bariatrique primaire.Méthodes : Nous avons procédé à un examen rétrospectif des dossiers des patients de la clinique de révision bariatrique par rapport aux patients ayant subi une chirurgie bariatrique primaire entre décembre 2009 et juin 2014.Résultats : Nous avons examiné les dossiers de 2769 patients de la clinique bariatrique primaire, dont 886 avaient subi une chirurgie bariatrique, et 534 patients de la clinique de révision, dont 83 avaient subi une chirurgie de révision. Un moins grand nombre de patients de la clinique de révision ont subi une c...

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Section: Discussionmentioning

confidence: 99%

A comparison of revisional and primary bariatric surgery

Fulton

Sheppard

Birch

et al. 2017

CJS

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“…While there were only 12,000 bariatric surgeries performed in 1998, the American Society of Metabolic and Bariatric Surgery estimates a total of 179,000 bariatric surgeries performed in 2013 [1]. Depending on the type of bariatric procedure performed, a certain percentage of these operations result in inadequate weight loss or anatomic complications [2]. As a result, bariatric surgeons are now confronted with an increasing number of patients needing revisional bariatric surgery..…”

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confidence: 99%

Perioperative risk and complications of revisional bariatric surgery compared to primary Roux-en-Y gastric bypass

et al. 2014

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“…In experienced hands, revisional bariatric surgery can be performed laparoscopically in a safe way with low complication ratesand excellent results on additional weight loss. [29,30] If metabolic surgeons want to gather and keep support in the provider community, they have the responsibility to report the results of primary and secondary bariatric procedures, hospitalization, complication rates and healthcare costsin a standardized way. There is need to reduce invasiveness of bariatric therapy and re-interventions in the futureto enhance societal support, and more importantly, to enable the treatment of more individuals.…”

Section: Resultsmentioning

confidence: 99%

Revisional bariatric surgery: An update

Debergh¹

2017

Laparosc Endosc Surg Sci

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Obesity can be defined as a chronic disease with a serious impact on an individual's quality of life; moreover, it is a leading risk factor for global death. Bariatric surgery has already proven its efficacy in providing the patient with a healthier life. Nonetheless, failure of initiated treatment can occur in medical practice. We can and should offer our patients correct, patient-tailored revisional therapy conducted by an experienced surgeon in a high-volume hospital facility. In this article, current indications and strategies for secondary bariatric procedures were summarized.

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Indications, safety, and feasibility of conversion of failed bariatric surgery to Roux-en-Y gastric bypass: a retrospective comparative study with primary laparoscopic Roux-en-Y gastric bypass

Abstract: In our series, hospital stay, morbidity, and mortality of rRYGB were not significantly higher compared with pLRYGB. Furthermore, we believe that this type of revisional bariatric surgery should be performed in high-volume bariatric centers.

Cited by 55 publications

References 23 publications

A comparison of revisional and primary bariatric surgery

A comparison of revisional and primary bariatric surgery

Perioperative risk and complications of revisional bariatric surgery compared to primary Roux-en-Y gastric bypass

Revisional bariatric surgery: An update

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