scholarly journals The Anatomy of a Weight Recidivism and Revision Bariatric Surgical Clinic

2014 ◽  
Vol 2014 ◽  
pp. 1-6 ◽  
Author(s):  
C. J. de Gara ◽  
S. Karmali
Keyword(s):  
Bariatric Surgery ◽  
Revisional Surgery ◽  
Vertical Band Gastroplasty ◽  
Laparoscopic Adjustable Gastric Band ◽  
Revisional Bariatric Surgery ◽  
Clinical Psychologist ◽  
Clinical Activity ◽  
Weight Recidivism ◽  
Primary Surgery ◽  
Early Results

Abstract. Weight recidivism in bariatric surgery failure is multifactorial. It ranges from inappropriate patient selection for primary surgery to technical/anatomic issues related to the original surgery. Most bariatric surgeons and centers focus on primary bariatric surgery while weight recidivism and its complications are very much secondary concerns.Methods. We report on our initial experience having established a dedicated weight recidivism and revisional bariatric surgery clinic. A single surgeon, dedicated nursing, dieticians, and psychologist developed care maps, goals of care, nonsurgical candidate rules, and discharge planning strategies.Results. A single year audit (2012) of clinical activity revealed 137 patients, with a mean age 49 ± 10.1 years (6 years older on average than in our primary clinic), 75% of whom were women with BMI 47 ± 11.5. Over three quarters had undergone a vertical band gastroplasty while 15% had had a laparoscopic adjustable gastric band. Only 27% of those attending clinic required further surgery. As for primary surgery, the role of the obesity expert clinical psychologist was a key component to achieving successful revision outcomes.Conclusion. With an exponential rise in obesity and a concomitant major increase in bariatric surgery, an inevitable increase in revisional surgery is becoming a reality. Anticipating this increase in activity, Alberta Health Services, Alberta, Canada, has established a unique and dedicated clinic whose early results are promising.

scholarly journals Revisional surgery in severe nutritional complications after bariatric surgical procedures: report of four cases from a single institution and review of the literature

2021 ◽  
Vol 48 ◽  
Author(s):  
JOÃO GABRIEL ROMERO BRAGA ◽  
MATHEUS MATHEDI CONCON ◽  
AMANDA PEREIRA LIMA ◽  
GUILHERME HOVERTER CALLEJAS ◽  
ARY DE CASTRO MACEDO ◽  
...  
Keyword(s):  
Bariatric Surgery ◽  
Weight Loss ◽  
Biliopancreatic Diversion ◽  
Revisional Surgery ◽  
Case Reports ◽  
Case Series ◽  
Morbidly Obese ◽  
Review Of The Literature ◽  
Primary Surgery ◽  
Nutritional Complications

ABSTRACT Introduction: bariatric surgery is currently the only treatment that leads to long-term and sustained weight loss and decreased morbidity and mortality in morbidly obese individuals. Roux-en-Y bypass causes weight loss by restricting food intake associated with reduced intestinal absorption, in addition to multiple endocrine and satiogenic effects. Biliopancreatic diversion promotes weight loss mainly due to poor absorption of the nutrients ingested. Both procedures exclude parts of the gastrointestinal tract. Objective: to describe four cases of revisional surgery after primary bariatric surgery, due to serious nutritional complications, and to review the literature regarding this subject. Methods: a retrospective analysis of patients of Unicamps bariatric center database and review of the literatures were performed. Results: four patients were identified, 2 women and 2 men, with a mean age of 48 years. The mean body mass index before revisional surgery was 23.7 kg/m2. Three patients underwent Scopinaro biliopancreatic diversion, and onde patient underwent Roux-en-Y gastric bypass. The revisional surgeries were revision, conversion, and reversion. One patient died. For the review of the literature 12 articles remained (11 case reports and 1 case series). Another five important original articles were included. Conclusion: fortunately, revision surgery is rarely necessary, but when indicated it has increased morbidity, It can be revision, reverion or conversion according to the severity of the patient and the primary surgery performed.

Title: Initial results of reoperative bariatric surgery: a retrospective feasibility and safety study at a low-volume unit

2021 ◽  
Author(s):  
Sheng Mao Wu ◽  
Hung Chieh Lo
Keyword(s):  
Bariatric Surgery ◽  
Weight Loss ◽  
Revisional Surgery ◽  
Marginal Ulcer ◽  
Revisional Bariatric Surgery ◽  
Conversion To Open Surgery ◽  
Reoperative Bariatric Surgery ◽  
Low Volume ◽  
Volume Unit ◽  
Robust Evidence

Abstract Background This study assessed the feasibility and results of revisional bariatric surgery at a low-volume unit.Methods This retrospective study was conducted from January 2017 to August 2020; the revision group comprised patients treated for weight regain (WR, n = 6), insufficient weight loss (IWL, n =3), and various complications (n=6). Clinical characteristics and 30-day outcomes were assessed and compared with those of primary bariatric procedures (control, n=173). Results A total of 8.0% (15/188) of patients underwent revisional procedures and tended to be elderly (40.1 vs. 38.2 years), be female (73.3% vs. 54.9%), and have a significantly lower body mass index (33.1 vs. 39.9 kg/m2) and fewer comorbidities than controls. Gastric bypass was the most prevalent revisional procedure. A significantly longer operative duration (155 and 96 min; p < 0.001), longer length of stay (3.7 and 2.4 days) and higher 30-day complication rate (20.0% vs. 4.6%) were found in the revision group, including one case of leakage and another of jejunojejunostomy obstruction. There were no cases of conversion to open surgery or mortality. A total of 5/6 WR patients achieved excessive weight loss >50%, versus only one IWL patient who reached this goal. Complications, including marginal ulcer, fistula and post-sleeve gastrectomy stenosis, were alleviated after revision.Conclusion Revisional surgery appears to be feasible and effective in a low-volume practice in patients with WR and complications after primary bariatric procedures; however, the benefits should be weighed against the risks. More robust evidence is required to support ongoing practice.

scholarly journals FROM COMPLEX EVOLVING TO SIMPLE: CURRENT REVISIONAL AND ENDOSCOPIC PROCEDURES FOLLOWING BARIATRIC SURGERY

2016 ◽  
Vol 29 (suppl 1) ◽  
pp. 128-133 ◽  
Author(s):  
Ricardo ZORRON ◽  
Manoel Passos GALVÃO-NETO ◽  
Josemberg CAMPOS ◽  
Alcides José BRANCO ◽  
José SAMPAIO ◽  
...  
Keyword(s):  
Bariatric Surgery ◽  
Sleeve Gastrectomy ◽  
Treatment Failure ◽  
Revisional Surgery ◽  
Laparoscopic Approach ◽  
Revisional Bariatric Surgery ◽  
Surgical Approaches ◽  
Gastrojejunal Anastomosis ◽  
Partial Pancreatectomy ◽  
Endoscopic Procedures

ABSTRACT Background: Roux-en-Y gastric bypass (RYGB) is a standard therapy in bariatric surgery. Sleeve gastrectomy and gastric banding, although with good results in the literature, are showing higher rates of treatment failure to reduce obesity-associated morbidity and body weight. Other problems after bariatric may occur, as band erosion, gastroesophageal reflux disease and might be refractory to medication. Therefore, a laparoscopic conversion to a RYGB can be an effective alternative, as long as specific indications for revision are fulfilled. Objective: The objective of this study was to analyse own and literature data on revisional bariatric procedures to evaluate best alternatives to current practice. Methods: Institutional experience and systematic review from the literature on revisional bariatric surgery. Results: Endoscopic procedures are recently applied to ameliorate failure and complications of bariatric procedures. Therapy failure following RYGB occurs in up to 20%. Transoral outlet reduction is currently an alternative method to reduce the gastrojejunal anastomosis. The diameter and volume of sleeve gastrectomy can enlarge as well, which can be reduced by endoscopic full-thickness sutures longitudinally. Dumping syndrome and severe hypoglycemic episodes (neuroglycopenia) can be present in patients following RYGB. The hypoglycemic episodes have to be evaluated and usually can be treated conventionally. To avoid partial pancreatectomy or conversion to normal anatomy, a new laparoscopic approach with remnant gastric resection and jejunal interposition can be applied in non-responders alternatively. Hypoglycemic episodes are ameliorated while weight loss is sustained. Conclusion: Revisional and endoscopic procedures following bariatric surgery in patients with collateral symptomatic or treatment failure can be applied. Conventional non-surgical approaches should have been applied intensively before a revisional surgery will be indicated. Former complex surgical revisional procedures are evolving to less complicated endoscopic solutions.

Revisional bariatric surgery, are we ready?

2019 ◽  
Vol 30 (4) ◽  
pp. 486-493
Author(s):  
R Villallonga Puy ◽  
A García-Ruiz de Gordejuela ◽  
MR Rodríguez Luna ◽  
Ó González ◽  
E Caubet ◽  
...  
Keyword(s):  
Bariatric Surgery ◽  
Revisional Bariatric Surgery ◽  
Center Of Excellence

Resumen Introducción: la obesidad en el siglo XXI continúa siendo un problema de salud mundial, la cirugía bariátrica, en la actualidad, es el único tratamiento exitoso a largo plazo para el manejo de ésta y sus comorbilidades, ha tenido un incremento importante en los últimos años apareciendo complicaciones que son objetivos de la cirugía revisional. Objetivos: el presente artículo pretende evaluar las principales cirugías revisionales que han permeado en el campo de la cirugía bariátrica así como nuestra experiencia en los últimos años. Material y métodos: análisis estadístico descriptivo de una cohorte retrospectiva de pacientes sometidos a cirugía de revisión en el Hospital Universitario Vall d'Hebron de Barcelona, España. EAC-BS Center of Excellence. Resultados: se han realizado 1.890 cirugías bariátricas desde los inicios de la cirugía bariátrica en nuestra Unidad hasta el 31 de julio de 2019. 143 (7,56%) corresponden a cirugías de revisión. Las más frecuentes fueron la conversión de gastrectomía vertical (GV) a bypass gástrico (BPG) 30,76% y a SADI-S 20,97%. Dentro de éstas, las principales indicaciones se encuentra el reflujo esofagogástrico (RGE) en un 30,76% y pérdida inadecuada de peso 20,97% en la GV. El BPG requirió conversión a GV en 12,58% y revisión de BGP en 7,69% principalmente por hipoglucemias. Conclusiones: el incremento de cirugía primaria para la obesidad implica que un porcentaje considerable de procedimientos primarios presentarán algún tipo de indicación que requerirá revisión. La cirugía revisional requerirá una evaluación meticulosa debería permitir dar un buen manejo a largo plazo.

How Far Can Our Expectations Go on Revisional Bariatric Surgery After Failed Adjustable Gastric Banding?

2021 ◽  
Author(s):  
André Pereira ◽  
◽  
André Costa Pinho ◽  
Hugo Santos Sousa ◽  
Eduardo Lima da Costa ◽  
...  
Keyword(s):  
Bariatric Surgery ◽  
Gastric Banding ◽  
Adjustable Gastric Banding ◽  
Revisional Bariatric Surgery

Robotic Revisional Bariatric Surgery: a High-Volume Center Experience

2021 ◽  
Author(s):  
Nicolas H. Dreifuss ◽  
Alberto Mangano ◽  
Chandra Hassan ◽  
Mario A. Masrur
Keyword(s):  
Bariatric Surgery ◽  
High Volume ◽  
Revisional Bariatric Surgery ◽  
High Volume Center
Sign in / Sign up

Export Citation Format

Share Document