title: Revision of failed bariatric procedures to Roux-en-Y gastric bypass (RYGB).
abstract: Bariatric surgery for morbid obesity has been established as an effective treatment method and has been shown to be associated with resolution of co-morbidities. Despite its success, some patients may require revision because of weight regain or mechanical complications. From September 2005 to December 2009, 42 patients underwent revisional Roux-en-Y gastric bypass (RYGB). All procedures were performed by one surgeon. Demographics, indications for revision, complications, and weight loss were reviewed. Thirty-seven patients were treated with laparoscopic (n = 36) or open (n = 1) RYGB after failed laparoscopic adjustable gastric banding. Four patient were treated with laparoscopic (n = 3) or open (n-1) RYGB after failed vertical banded gastroplasty, and one patient underwent open redo RYGB due to large gastric pouch. Conversion rate from laparoscopy to open surgery was 2.5% (one patient). Mean operative time was 145.83 ± 35.19 min, and hospital stay was 3.36 ± 1.20 days. There was no mortality. Early and late complications occurred in six patients (14.2%). The mean follow-up was 15.83 ± 13.43 months. Mean preoperative body mass index was 45.15 ± 7.95 that decreased to 35.23 ± 6.7, and mean percentage excess weight loss was 41.19 ± 20.22 after RYGB within our follow-up period. RYGB as a revisional bariatric procedure is effective to treat complications of restrictive procedures and to further reduce weight in morbidly obese patients.
authors.affiliation: Department of Surgery, Faculty of Medicine, Kuwait University, Safat, Kuwait. khoursheed@hsc.edu.kw
authors.forename: Mousa A
authors.initials: MA
authors.lastname: Khoursheed
authors.forename: Ibtisam A
authors.initials: IA
authors.lastname: Al-Bader
authors.forename: Fahad S
authors.initials: FS
authors.lastname: Al-asfar
authors.forename: Ali I
authors.initials: AI
authors.lastname: Mohammad
authors.forename: Mumtaz
authors.initials: M
authors.lastname: Shukkur
authors.forename: Hussain M
authors.initials: HM
authors.lastname: Dashti
mesh_terms: D000328:Adult; D005260:Female; D015390:Gastric Bypass / Q000379:methods*; D006801:Humans; D010535:Laparoscopy; D008297:Male; D008875:Middle Aged; D009767:Obesity, Morbid / Q000601:surgery*; D012086:Reoperation; D012189:Retrospective Studies; D017211:Treatment Failure; D015431:Weight Loss