TU1.2 Revisional Bariatric Surgery: 7-Year Experience from a Tertiary Institution

Abstract

Abstract Background Revisional surgery is an expanding area in bariatric surgery which reflects a rising need to treat adverse sequelae of primary procedures. Despite the increase, their safety and efficacy remain unclear. We aimed to review revisional bariatric surgery indications and outcomes at our tertiary centre. Methods Data on revisional bariatric surgery was collected prospectively from 2013 and analysed retrospectively, including indications and postoperative outcomes. Results From January 2013 to December 2021, 80 patients (mean age: 51.4 years) undergoing revisional surgery were identified: 38 laparoscopic gastric band (LGB) to Roux-en-Y gastric bypasses (RYGB), 34 sleeve gastrectomies (SG) to RYGB, 6 mini-gastric bypasses (MGB) to RYGB and 2 RYGB revisions. The most common indication for revision was weight regain (56.4%) followed by intolerable reflux (21.3%). Other indications included band complications (15%), obesity-related problems (2.5%), excessive weight loss (2.5%), corkscrewing of sleeve (1.3%), and dumping syndrome (1.3%). There were 11 post-operative complications, with mean length of stay of 2.8 days. In addition to treating primary complications, the mean change in BMI at 12 months for LGB to RYGB revisions and SG to RYGB revisions was -9.5 and -5.3 respectively. Average change in BMI at 24 months for LGB to RYGB revisions and SG to RYGB revisions was -9.4 and -8.6 respectively. Conclusion Revisional bariatric surgery effectively treated the undesirable results from primary surgery. Laparoscopic revisional surgery can be performed after both failed open and laparoscopic procedures with minimal complications. In experienced hands, with careful patient selection & education, satisfactory additional weight loss can be achieved.