title: Laparoscopic Roux-en-Y gastric bypass as a revision procedure after restrictive bariatric surgery.
abstract: BACKGROUND
  Adjustable gastric banding (AGB) and vertical banded gastroplasty (VBG) have been extensively used to treat morbid obesity. Patients with insufficient weight loss or complications may require surgical revision. The laparoscopic Roux-en-Y gastric bypass (LRYGBP) is one of the most common procedures currently used for revision. The aim of the study was to analyze surgical outcomes of 30 consecutive patients who underwent revision to LRYGBP in a 2-year period.
  
  
  METHODS
  The prospectively constructed database and the medical records of all patients undergoing revision to LRYGBP were reviewed. Demographics, surgical details, results, and complications were analyzed.
  
  
  RESULTS
  There were 23 women and seven men with a mean age of 41.1+/-9.7 years (r=25-61). Mean body mass index (BMI) was 40.0+/-7.5 kg/m(2) (r=27.2-65.2). Initial operation was AGB in 24, VBG in five, and both in one patient. In ten patients, the band had been removed before revision, in 13 cases, band removal and LRYGBP were performed in one surgical intervention, and in two patients, it was performed in a two-step surgery. There were two conversions to open surgery. Five patients presented major surgical complications. Hospital stay averaged 5.1 days (r=3-25). Mean percent excess body weight loss at 6 and 12 months was 61.7+/-27.5 and 81.2+/-20.5 kg/m(2), respectively. Mean percent low body mass index at 6 and 12 months was 22.5+/-9.1 and 29.1+/-11.4 kg/m(2), respectively.
  
  
  CONCLUSIONS
  LRYGBP as a revision procedure is feasible in most patients. Surgical complications are more frequent.
authors.affiliation: The Obesity Clinic, American British Cowdray Medical Center, Sur 136 #116 Colonia Las Américas, 01120 Mexico City, Mexico.
authors.forename: Hugo
authors.initials: H
authors.lastname: Sanchez
authors.forename: Alfredo
authors.initials: A
authors.lastname: Cabrera
authors.forename: Karina
authors.initials: K
authors.lastname: Cabrera
authors.forename: Carlos
authors.initials: C
authors.lastname: Zerrweck
authors.forename: Maureen
authors.initials: M
authors.lastname: Mosti
authors.forename: Mauricio
authors.initials: M
authors.lastname: Sierra
authors.forename: Guillermo
authors.initials: G
authors.lastname: Dominguez
authors.forename: Miguel F
authors.initials: MF
authors.lastname: Herrera