Laparoscopic revision of R oux‐en‐Y gastric bypass to sleeve gastrectomy: A ray of hope for failed R oux‐en‐Y gastric bypass
Abstract
Introduction Roux-en-Y gastric bypass (RYGB) is the most commonly performed bariatric operation across the world, but sometimes revision is necessary. Inadequate weight loss, weight regain, and complications such as dumping syndrome are common reasons for revision. We report the 1-year outcomes of five patients who underwent laparoscopic conversion of RYGB to sleeve gastrectomy during surgical revision. Methods Mean age was 38.8 ± 9.1 years. Mean BMI at primary surgery was 57.9 ± 8.1 kg/m(2) . Two patients were diabetic and sleep apneic. One was hypertensive. All patients underwent a RYGB as the primary weight loss procedure. Mean weight loss was 36.8 ± 8.6 kg (excess weight loss = 39.8 ± 14.9%) at 2 years. At the end of 5 years, these patients regained 10.9 ± 4.1 kg (31.5 ± 13.6% of excess weight loss). Primary indications for revision surgery were failure to lose weight, weight regain, and intractable dumping syndrome. Mean duration between primary and revision surgery was 6.2 ± 1.1 years. RYGB was converted to sleeve gastrectomy as a first stage in all cases. Results Mean duration of revision surgery was 120.0 ± 15.5 min. Mean blood loss was 70 ± 50 mL. One year after revision surgery, a mean weight loss of 21.5 ± 10.5 kg was achieved (mean excess weight loss = 35.8 ± 8.8%). Two patients with type 2 diabetes mellitus and the one with hypertension achieved remission. Dumping was resolved. There were no complications. Conclusion Laparoscopic conversion of RYGB to sleeve gast…
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Various surgical re-interventions have been used, including gastric tube placement, gastric bypass reversal with or without concomitant sleeve resection and gastric pouch restriction.
“Various surgical re-interventions have been used, including gastric tube placement, gastric bypass reversal with or without concomitant sleeve resection and gastric pouch restriction (Table 5) (66,103,105-123).”
From Dumping syndrome after esophageal, gastric or bariatric surgery: Pathophysiology, diagnosis, and management (2017) · cites this paper as [111]
Approximately 24% of patients who underwent surgical re-intervention because of refractory severe post-Roux-en-Y gastric bypass hypoglycemia received a gastric bypass reversal and approximately 9% had gastric pouch restriction.
“As shown in Table 5, approximately 24% of patients who underwent surgical re-intervention because of refractory severe post-Roux-en-Y gastric bypass hypoglycemia received a gastric bypass reversal (66,103,106-113) and approximately 9% had gastric pouch restriction (66,114,115).”
From Dumping syndrome after esophageal, gastric or bariatric surgery: Pathophysiology, diagnosis, and management (2017) · cites this paper as [111]
Cites
Vilallonga, R., van de Vrande, S., & Himpens, J. (2013) · Surgical Endoscopy · doi:10.1007/s00464-013-3087-0 · Cited by 85 · cited 1× · see citing works
“However, it remains one of the main indications for reversal of RYGB along with marginal ulceration, excessive weight loss, and malnutrition (28).”
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van Beek, A. P., Emous, M., Laville, M., & Tack, J. (2017) · Obesity Reviews · doi:10.1111/obr.12467 · Cited by 288 · see citing works
“(111) Case series N = 5 Laparoscopic conversion”
Background
- Authors
- Lakdawala, M., Limas, P., Dhar, S., Remedios, C., Dhulla, N., Sood, A., & Bhasker, A. G.
- Affiliations
- Saifee Hospital (IN)
- Sultan Abdul Halim Hospital (MY)
- Centre for Obesity and Digestive Surgery Mumbai India
- Corresponding author
- Bhasker, Aparna Govil
- Venue
- Asian Journal of Endoscopic Surgery
- Publisher
- Wiley
- Published
- 2016-03-04
- Volume
- 9
- Issue
- 2
- Pages
- 122-127
- ISSN
- 1758-5902 (ISSN-L)
- 1758-5910
- OpenAlex
- W2293896959
- Cited by
- 17
- References
- 1
- Citations by year
- 2026: 1 · 2025: 1 · 2024: 2 · 2023: 2 · 2022: 1 · 2021: 2 · 2020: 2 · 2019: 2 · 2018: 1 · 2017: 1 · 2016: 2
- FWCI
- 2.21
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Asian Journal of Endoscopic Surgery (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Surgery › Bariatric Surgery and Outcomes
- Health Sciences › Medicine › Surgery › Minimally Invasive Surgical Techniques
- Health Sciences › Medicine › Surgery › Body Contouring and Surgery
- Keywords
- Roux-en-Y gastric bypass, sleeve gastrectomy, revisional bariatric surgery, laparoscopic conversion, weight regain, dumping syndrome, excess weight loss, type 2 diabetes remission, obesity
- MeSH terms
- Adult, Female, Follow-Up Studies, Gastrectomy, Humans, Male, Middle Aged, Obesity, Morbid, Laparoscopy, Reoperation, Gastric Bypass, Weight Loss, Treatment Failure
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