BACKGROUND: The Roux-en-Y gastric bypass (RYGB) is a very effective treatment for obesity and its related co-morbidities. However, some patients fail to achieve>50% of their excess weight loss (EWL), and others regain much of the weight that they lost. OBJECTIVE: The purpose of this study was to analyze early outcomes after conversion of RYGB to duodenal switch (DS) in terms of weight loss, change in co-morbidities, and complications. SETTING: This is a retrospective analysis from 1 surgeon at a single private institution. METHODS: We analyzed data from 32 obese patients retrospectively who underwent revision for failed RYGB. Nine patients underwent DS with Roux-en-Y reconstruction (RYDS), and 23 patients underwent single anastomosis DS between October 2012 and December 2015. Regression analyses were performed for all follow-up weight-loss data. RESULTS: The patients experienced mean EWL of 16.2% over an average of 16 years (range: 0-38) with their primary RYGB surgery. Of 32 patients who underwent revision DS, 22 patients are beyond the 1-year postoperative mark (follow-up 81.8%), and 15 patients are beyond the 2-year postoperative mark (follow-up 73.3%). One patient was lost to follow-up. The patients experienced mean EWL of 31.2%, 45.1%, 51%, 54.2%, 56%, and 56.4% at 3, 6, 9, 12, 18, and 24 months, respectively, after their revisional surgery. Mean total weight loss achieved at 12 and 24 months was 27.7% and 29.2%, respectively. There was no statistical significant difference in mean %EWL at 12 months (P = .468) and 24 months (P = .266) between RYDS and single anastomosis DS. CONCLUSION: A laparoscopic revision from RYGB to DS is an effective weight-loss operation with midterm follow-up of 2 years. Though long-term follow-up is warranted to measure recidivism, the initial data seem favorable.
BACKGROUND: The Roux-en-Y gastric bypass (RYGB) is a very effective treatment for obesity and its related co-morbidities. However, some patients fail to achieve>50% of their excess weight loss (EWL), and others regain much of the weight that they lost. OBJECTIVE: The purpose of this study was to analyze early outcomes after conversion of RYGB to duodenal switch (DS) in terms of weight loss, change in co-morbidities, and complications. SETTING: This is a retrospective analysis from 1 surgeon at a single private institution. METHODS: We analyzed data from 32 obesepatients retrospectively who underwent revision for failed RYGB. Nine patients underwent DS with Roux-en-Y reconstruction (RYDS), and 23 patients underwent single anastomosis DS between October 2012 and December 2015. Regression analyses were performed for all follow-up weight-loss data. RESULTS: The patients experienced mean EWL of 16.2% over an average of 16 years (range: 0-38) with their primary RYGB surgery. Of 32 patients who underwent revision DS, 22 patients are beyond the 1-year postoperative mark (follow-up 81.8%), and 15 patients are beyond the 2-year postoperative mark (follow-up 73.3%). One patient was lost to follow-up. The patients experienced mean EWL of 31.2%, 45.1%, 51%, 54.2%, 56%, and 56.4% at 3, 6, 9, 12, 18, and 24 months, respectively, after their revisional surgery. Mean total weight loss achieved at 12 and 24 months was 27.7% and 29.2%, respectively. There was no statistical significant difference in mean %EWL at 12 months (P = .468) and 24 months (P = .266) between RYDS and single anastomosis DS. CONCLUSION: A laparoscopic revision from RYGB to DS is an effective weight-loss operation with midterm follow-up of 2 years. Though long-term follow-up is warranted to measure recidivism, the initial data seem favorable.
Authors: Amit Surve; Hinali Zaveri; Daniel Cottam; LeGrand Belnap; Walter Medlin; Christina Richards; Austin Cottam; Samuel Cottam Journal: Surg Endosc Date: 2017-01-11 Impact factor: 4.584
Authors: Amit Surve; Ravi Rao; Daniel Cottam; Aditya Rao; Leila Ide; Samuel Cottam; Benjamin Horsley Journal: Obes Surg Date: 2020-04 Impact factor: 4.129
Authors: Francesco Pennestrì; Luca Sessa; Francesca Prioli; Pierpaolo Gallucci; Luigi Ciccoritti; Francesco Greco; Carmela De Crea; Marco Raffaelli Journal: Updates Surg Date: 2022-09-25
Authors: Hinali Zaveri; Amit Surve; Daniel Cottam; Austin Cottam; Walter Medlin; Christina Richards; LeGrand Belnap; Samuel Cottam; Benjamin Horsley Journal: Obes Surg Date: 2018-10 Impact factor: 4.129
Authors: Bo T Neichoy; Bleu Schniederjan; Daniel R Cottam; Amit K Surve; Hinali M Zaveri; Austin Cottam; Samuel Cottam Journal: JSLS Date: 2018 Jan-Mar Impact factor: 2.172