Muffazal Lakdawala1,2, Peter Limas1,3, Shilpa Dhar1, Carlyne Remedios1, Neha Dhulla1, Amit Sood1,2, Aparna Govil Bhasker1,2. 1. Centre for Obesity and Digestive Surgery, Mumbai, India. 2. Department of Bariatric and Metabolic Surgery, Institute of Minimally Invasive Surgical Sciences and Research Centre, Saifee Hospital, Mumbai, India. 3. Gading Pluit Hospital, Kelapa Gading, Indonesia.
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 gastrectomy as a first stage may be considered as an additional option in the armamentarium of revision procedures after RYGB.
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 gastrectomy as a first stage may be considered as an additional option in the armamentarium of revision procedures after RYGB.
Authors: Ben Gys; Philip Plaeke; Bas Lamme; Thierry Lafullarde; Niels Komen; Anthony Beunis; Guy Hubens Journal: Obes Surg Date: 2019-06 Impact factor: 4.129
Authors: Emidio Scarpellini; Joris Arts; George Karamanolis; Anna Laurenius; Walter Siquini; Hidekazu Suzuki; Andrew Ukleja; Andre Van Beek; Tim Vanuytsel; Serhat Bor; Eugene Ceppa; Carlo Di Lorenzo; Marloes Emous; Heinz Hammer; Per Hellström; Martine Laville; Lars Lundell; Ad Masclee; Patrick Ritz; Jan Tack Journal: Nat Rev Endocrinol Date: 2020-05-26 Impact factor: 43.330