Revisional Bariatric Surgery for Unsuccessful Weight Loss and Complications

Shimizu, Hiroki; Annaberdyev, Shohrat; Motamarry, Isaac; Kroh, Matthew; Schauer, Philip R.; Brethauer, Stacy A.

doi:10.1007/s11695-013-1012-1

Cited by 128 publications

(76 citation statements)

References 53 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Obesity surgery literature shows that although the procedure is the best evidence-based obesity treatment for weight loss and weight loss maintenance to date, 20-30% of people start to regain weight within 24 months [29]. Numbers of patients requiring revision surgery due to weight regain following their first procedures are growing with incident rates ranging from 5 to 56% [30,31]. Gastric bands patients report higher revision surgery rates [32].…”

Section: Discussionmentioning

confidence: 99%

Contrasting Views of the Post-bariatric Surgery Experience between Patients and their Practitioners: a Qualitative Study

Jumbe

Meyrick

2018

OBES SURG

View full text Add to dashboard Cite

Background The superiority of obesity surgery for improving medical and weight outcomes in severely obese patients when compared to other weight loss interventions remains undisputed. However, knowledge about the psychological impact of the procedure on patients' lives is limited. Systematic reviews indicate persisting psychological distress after surgery compared to control groups especially longer term, suggesting the need for postoperative psychological support and assessment. Research literature also infers limited knowledge regarding the postoperative patient experience of obesity surgery. This may form a barrier in health practitioners' understanding of these patients' ongoing needs. Methods Ten patients who had obesity surgery two or more years ago and eight obesity surgery practitioners were recruited within hospital settings and individually interviewed by the researcher to capture their accounts of the postoperative experience. Concordance between the two groups was explored to gauge awareness of patients' subsequent health needs. Results Thematic analysis of transcribed interviews elicited a key finding around 'post-surgical cliffs in patient care' within a heavily structured service. Participants reported some unmet needs, namely, psychological aftercare to facilitate adjustment following drastic weight loss and excess skin, acceptance of their non-obese self and perceived stigma. The impact of contrasting views of success between patients and practitioners on postoperative care within the service context was highlighted. Conclusions Obesity surgery is a great weight loss catalyst for severe obesity. However, lack of psychological aftercare may threaten early gains in health outcomes over the longer term. More qualitative and quantitative studies are needed to validate current study results.

show abstract

Section: Discussionmentioning

confidence: 99%

Contrasting Views of the Post-bariatric Surgery Experience between Patients and their Practitioners: a Qualitative Study

Jumbe

Meyrick

2018

OBES SURG

View full text Add to dashboard Cite

show abstract

“…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

CJS

View full text Add to dashboard Cite

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...

show abstract

“…Marceau et al reported excellent 20 years results after BPD-DS with a %EWL of over 70% [3], but Biron et al mentioned that weight regains after BPD-DS is an increasing problem, especially in super-obese patients, doubling the failure rate every five years with weight regain [16]. In our series, we identified 17 patients with weight regain at a median follow-up of more than 5 years In bariatric surgery, weight regain is a common problem [7,17,18]. Even after satisfactory weight loss, weight regain can occur if patients go back to bad eating habits and sedentary lifestyle [8,19].…”

Section: Discussionmentioning

confidence: 95%