title: Revisional Laparoscopic Gastric Pouch Resizing for Inadequate Weight Loss After Roux-en-Y Gastric Bypass.
abstract: BACKGROUND
  Weight regain due to gastric pouch dilatation after Roux-en-Y gastric bypass (RYGB) is seen more frequently after long-term follow-up. We studied the feasibility and safety of laparoscopic pouch resizing (LPR) for dilated gastric pouch after RYGB associated with inadequate weight loss.
  
  
  METHODS
  From 1st June 2011 to 1st September 2013, patients who underwent LPR after failed RYGB were retrospectively compared and analyzed. Data included patient demographics, comorbidity, indication for revision, preoperative weight and BMI, operative time, hospital stay, conversion rate, mean follow-up, body mass index (BMI) loss, percentage excess weight loss (%EWL), reoperation rate, morbidity, and mortality.
  
  
  RESULTS
  Out of 170 revisional bariatric procedures, 32 LPR (27/5, F/M) were performed for dilated gastric pouch after RYGB. The mean age, preoperative weight, and BMI were 38.3 ± 9.3 years, 101.7 ± 22.8 kg, 38.8 ± 6.4 kg/m(2), respectively. The median operative time and hospital stay were 100 min and 2 days, respectively. All pouch resizing procedures were carried out laparoscopically, with none requiring conversion to open surgery. The overall complication and reoperation rates were 15.6 and 3.1 %, respectively. There were no deaths. The mean follow-up was 14.1 ± 6.2 months. The mean postoperative BMI was 32.8 ± 7.3 kg/m(2), and the median %EWL was 29.1 %.
  
  
  CONCLUSIONS
  LPR is safe and can lead to adequate weight loss. However, long-term follow-up is needed to determine the efficiency and durability of this procedure.
authors.affiliation: Department of Surgery, Faculty of Medicine, Kuwait University, Safat, PO Box 24923, Jabriya, 13110, Kuwait.
authors.forename: Ibtisam
authors.initials: I
authors.lastname: Al-Bader
authors.forename: Mousa
authors.initials: M
authors.lastname: Khoursheed
authors.forename: Khalid
authors.initials: K
authors.lastname: Al Sharaf
authors.forename: D Ali
authors.initials: DA
authors.lastname: Mouzannar
authors.forename: Aqeel
authors.initials: A
authors.lastname: Ashraf
authors.forename: Abe
authors.initials: A
authors.lastname: Fingerhut
mesh_terms: D000328:Adult; D015992:Body Mass Index; D005240:Feasibility Studies; D005260:Female; D015390:Gastric Bypass / Q000009:adverse effects / Q000379:methods; D006801:Humans; D010535:Laparoscopy / Q000009:adverse effects / Q000379:methods*; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D009767:Obesity, Morbid / Q000453:epidemiology / Q000473:pathology / Q000601:surgery*; D061646:Operative Time; D009929:Organ Size; D012086:Reoperation / Q000009:adverse effects; D012189:Retrospective Studies; D013270:Stomach / Q000473:pathology / Q000601:surgery*; D017211:Treatment Failure; D015431:Weight Loss