Outcomes of revisional bariatric surgery in patient with hypermobile Ehlers–Danlos syndrome

Ehlers–Danlos syndrome (EDS), a rare group of inherited connective tissue disorders caused by alterations in collagen synthesis, has the potential for disrupted tissue healing leading to morbidity in patients undergoing gastrointestinal surgery. There is a paucity of literature on the safety of metabolic and bariatric surgery (MBS) in individuals with a diagnosis of EDS. We report on the outcomes of a patient with hypermobile subtype EDS who underwent sleeve gastrectomy for management of class III obesity. The patient underwent revisional Roux-en-Y gastric bypass for insufficient weight loss, without increased morbidity. This report suggests that primary (stapled) and revisional (anastomotic) MBS are safe in individuals with hypermobile subtype EDS. However, there are 13 subtypes of EDS, and it is likely that each is associated with different levels of surgical risk. A thorough discussion of potential implications of a diagnosis of EDS should be part of informed consent for MBS.