title: [Conversional and endoscopic procedures following bariatric surgery].
abstract: The Roux-en-Y gastric bypass (RYGB) is the therapy of choice in bariatric surgery. Sleeve gastrectomy and gastric banding are showing higher rates of treatment failure, reducing obesity-associated morbidity and body weight insufficiently. Moreover, gastroesophageal reflux disease (GERD) can occur refractory to medication. Therefore, a laparoscopic conversion to RYGB can be reasonable as long as specific conditions are fulfilled.Endoscopic procedures are currently being applied to revise bariatric procedures. Therapy failure following RYGB occurs in up to 20 % of cases. Transoral outlet reduction is the minimally invasive method of choice to reduce gastrojejunal anastomosis of the alimentary limb. The diameter of a gastric sleeve can be unwantedly enlarged as well; that can be reduced by placement of a longitudinal full-thickness suture.Severe hypoglycemic episodes can be present in patients following RYGB. Hypoglycemic episodes have to be diagnosed first and can be treated conventionally. Alternatively, a laparoscopic approach according to Branco-Zorron can be used for non-responders. Hypoglycemic episodes can thus be prevented and body weight reduction can be assured.Conversional and endoscopic procedures can be used in patients with treatment failure following bariatric surgery. Note that non-invasive approaches should have been applied intensively before a revisional procedure is performed.
authors: Zentrum für Innovative Chirurgie (ZIC), Klinik für Chirurgie, Campus Virchow-Klinikum und Campus Mitte, Charité-Universitätsmedizin Berlin, Augustenburger Platz 1, Berlin, Deutschland. ricardo.zorron@charite.de.
authors: R
authors: R
authors: Zorron
authors: Klinik für Allgemein-, Viszeral-, Thorax- und Gefäßchirurgie, Klinikum Bremerhaven Reinkenheide, Bremerhaven, Deutschland.
authors: C
authors: C
authors: Bothe
authors: Klinik für Allgemein-, Viszeral-, Thorax- und Gefäßchirurgie, Klinikum Bremerhaven Reinkenheide, Bremerhaven, Deutschland.
authors: T
authors: T
authors: Junghans
authors: Zentrum für Innovative Chirurgie (ZIC), Klinik für Chirurgie, Campus Virchow-Klinikum und Campus Mitte, Charité-Universitätsmedizin Berlin, Augustenburger Platz 1, Berlin, Deutschland.
authors: J
authors: J
authors: Pratschke
authors: Zentrum für Innovative Chirurgie (ZIC), Klinik für Chirurgie, Campus Virchow-Klinikum und Campus Mitte, Charité-Universitätsmedizin Berlin, Augustenburger Platz 1, Berlin, Deutschland.
authors: C
authors: C
authors: Benzing
authors: Zentrum für Innovative Chirurgie (ZIC), Klinik für Chirurgie, Campus Virchow-Klinikum und Campus Mitte, Charité-Universitätsmedizin Berlin, Augustenburger Platz 1, Berlin, Deutschland.|Berlin Institute of Health (BIH), Berlin, Deutschland.
authors: F
authors: F
authors: Krenzien
mesh_terms: D050110:Bariatric Surgery / Q000295:instrumentation / Q000379:methods*; D015992:Body Mass Index; D061887:Conversion to Open Surgery / Q000295:instrumentation / Q000379:methods*; D016099:Endoscopy, Gastrointestinal / Q000295:instrumentation / Q000379:methods; D006801:Humans; D012086:Reoperation / Q000295:instrumentation / Q000379:methods; D013525:Surgical Instruments; D015431:Weight Loss
keywords: Bariatric surgery; Endoscopy; Gastric banding; Gastric bypass; Operative technique