Key result
Reoperative bariatric surgery following sleeve gastrectomy resulted in adequate weight loss, with mean BMI decreasing from 42.7 kg/m2 to 32.6 kg/m2 at 1 year, alongside acceptable complication rates.
Why the study?
Approximately 20%-30% of patients present with weight loss failure or reflux after laparoscopic sleeve gastrectomy, potentially requiring reoperative surgery.
Does reoperative bariatric surgery improve weight loss and comorbidities in patients with prior laparoscopic sleeve gastrectomy?
Observational (n=26)
No
Does reoperative bariatric surgery improve weight loss and comorbidities in patients with prior laparoscopic sleeve gastrectomy?
Absolute Event Rate: 32.6% vs 42.7%
Reoperative bariatric surgery following sleeve gastrectomy provides adequate weight loss with acceptable complication rates, though band placement may increase complications.
Reoperative surgery after SG may yield adequate weight loss with acceptable complications in select cases; leaves open optimal technique and banding risks pending larger studies.
INTRODUCTION: Laparoscopic sleeve gastrectomy (SG) is the most common bariatric surgical procedure worldwide. Approximately 20%-30% of patients present with weight loss failure or reflux following SG, which might require reoperative surgery. We present the surgical outcomes and complications following reoperative bariatric surgery at a tertiary care centre. PATIENTS AND METHODS: Prospectively collected data of all patients undergoing reoperative bariatric surgery from 2008 to 2021 were analysed retrospectively. Weight loss, resolution of comorbidities and complications following reoperative surgery were evaluated. RESULTS: Twenty-six patients were included in the study. The mean age was 38.8 (10.8) years. The primary procedure performed was laparoscopic SG in all cases. Nine patients underwent Roux en Y gastric bypass (RYGB) (one banded RYGB) and 14 underwent one anastomosis gastric bypass (OAGB) (three-banded OAGB). Three patients underwent resleeve. The most common indication was weight loss failure (65.3%). Fifteen patients were diagnosed to have hiatal hernia intraoperatively and concomitant repair was performed. The mean body mass index before revision surgery was 42.7 (9.8). It was 32.6 (5.7) kg/m2 and 33.0 (6.1) kg/m2 at 1 and 3 years, respectively. Age and pre-revision surgery excess weight correlated with weight loss (r = -0.79 and r = 0.99, respectively). Leak and bleeding occurred in one and two patients, respectively. There were two band-related complications and one 30-day mortality. CONCLUSION: Re-operative bariatric surgery following SG has adequate weight loss with acceptable complication rates. Band placement in re-operative surgery might lead to a higher complication rate.
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Singla et al. (2023) conducted an observational in Weight loss failure or reflux following laparoscopic sleeve gastrectomy (n=26). Reoperative bariatric surgery vs. Baseline was evaluated on Mean body mass index at 1 year. Reoperative bariatric surgery following sleeve gastrectomy resulted in adequate weight loss, with mean BMI decreasing from 42.7 kg/m2 to 32.6 kg/m2 at 1 year, alongside acceptable complication rates.
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