Laparoscopic revision of bariatric procedures: Is it feasible?

Leena Khaitan, Kent Van Sickle, Rodrigo Gonzalez, Edward Lin, Bruce Ramshaw, C. Daniel Smith, Charles D. Procter, Michael G. Sarr, William O. Richards, Daniel Scott, Leena Khaitan

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60 Scopus citations

Abstract

Reoperative bariatric surgery is required in 10 per cent to 20 per cent of patients secondary to weight regain or complications of the previous procedure. This study evaluates the feasibility of performing the revision procedure laparoscopically. A retrospective review of all patients undergoing revision of a previous weight loss procedure between October 1998 and November 2003 was conducted. Demographics, indications for surgery, operative findings, and complications were reviewed. Thirty-nine revisions were performed in 37 patients. Indications for revision were failure to lose weight (22), gastric outlet stricture (10), refractory gastroesophageal reflux (GERD) (6), and blind loop syndrome (1). All 39 procedures were revised to Roux-en-Y gastric bypass (RYGBP), with 18 open revisions (OR) and 21 laparoscopic revisions (LR). Ten of the 21 LR (48%) were converted to an open procedure due to adhesions or unclear anatomy. Early complications requiring operation were noted in five procedures (two OR, three LR). Nine patients (seven OR, two LR) required surgery at least 3 months following their revision. One patient died (LR). The difference in body mass index (kg/m2) (BMI) pre- and post-op was 43.3 ± 9.9 versus 37.4 ± 9.2, P = 0.01 (follow-up 5 months), but no significant BMI differences between LR and OR patients were seen. Revisional bariatric surgery is associated with more complications requiring surgery early in the laparoscopic population versus more late complications in those approached open. Revisional bariatric surgery can be approached laparoscopically and with acceptable morbidity comparable to patients whose revision is approached open.

Original languageEnglish (US)
Pages (from-to)6-12
Number of pages7
JournalAmerican Surgeon
Volume71
Issue number1
StatePublished - Dec 1 2005

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ASJC Scopus subject areas

  • Surgery

Cite this

Khaitan, L., Van Sickle, K., Gonzalez, R., Lin, E., Ramshaw, B., Smith, C. D., Procter, C. D., Sarr, M. G., Richards, W. O., Scott, D., & Khaitan, L. (2005). Laparoscopic revision of bariatric procedures: Is it feasible? American Surgeon, 71(1), 6-12.