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Related Experiment Video

Updated: Jan 23, 2026

Author Spotlight: Recent Advancements in Reoperative Foregut Surgery

Author Spotlight: Recent Advancements in Reoperative Foregut Surgery

Published on: September 22, 2023

The first consensus statement on revisional bariatric surgery using a modified Delphi approach.

Kamal K Mahawar¹, Jacques M Himpens², Scott A Shikora³

¹Bariatric Unit, Sunderland Royal Hospital, Sunderland, SR4 7TP, UK. kmahawar@gmail.com.

Surgical Endoscopy

|June 21, 2019

Summary

Revisional bariatric surgery (RBS) decisions should be individualized and multidisciplinary. Experts reached consensus on acceptable RBS procedures following gastric banding, sleeve gastrectomy, and Roux-Y gastric bypass, guiding future practice.

Keywords:

Band to bypass Band to sleeve Bariatric surgery Conversion Gastric banding Obesity surgery One anastomosis gastric bypass Revisional bariatric surgery Roux-en-Y gastric bypass Single-anastomosis duodeno-ileal bypass with sleeve gastrectomy Sleeve gastrectomy Sleeve to bypass Weight regain

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Area of Science:

Bariatric Surgery
Surgical Outcomes
Medical Consensus

Background:

Revisional bariatric surgery (RBS) addresses inadequate response or weight regain post-bariatric procedures.
This study presents findings from the first modified Delphi consensus-building exercise on RBS.

Framework:

A committee of 22 opinion leaders and 70 international experts in RBS participated.
Consensus was defined as agreement among ≥70.0% of experts on 39 statements regarding RBS.

Implementation:

Consensus was achieved on individualized and multidisciplinary decision-making for RBS (100% and 92.8%).
Preoperative evaluations including nutritional (95.7%), psychological (85.7%), endoscopy (97.1%), and contrast series (94.3%) were recommended.
Specific acceptable RBS procedures were identified for post-gastric banding (RYGB, OAGB, SADI-S) and post-sleeve gastrectomy (OAGB, BPD/DS, SADI-S).
Lengthening of the bilio-pancreatic limb was the consensus revision strategy after RYGB and OAGB.

Implications:

This consensus provides guidance for improving RBS outcomes.
Findings represent expert opinion, contributing to the development of robust evidence for future bariatric surgery practice.