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Author Spotlight: Recent Advancements in Reoperative Foregut Surgery
Published on: September 22, 2023
463
Decision-making Considerations in Revisional Bariatric Surgery.
Sheena Chen1, Jessica Chiang1, Omar Ghanem2
1Department of General Surgery, New York University Langone Health, Brooklyn, NY.
Summary
Revisional bariatric surgery approaches vary widely. The optimal strategy for revisional bariatric surgery depends on the patient
Area of Science:
- Bariatric Surgery
- Surgical Revision
- Obesity Management
Background:
- Significant variability exists in bariatric surgery practices.
- A lack of consensus hinders the standardization of optimal revisional bariatric surgery approaches.
Purpose of the Study:
- To consolidate existing literature on revisional bariatric surgery.
- To provide specific revision recommendations tailored to various index bariatric procedures.
Main Methods:
- Comprehensive literature review of bariatric surgery studies.
- Analysis of revision strategies for adjustable gastric band (AGB), sleeve gastrectomy (SG), Roux-en-Y gastric bypass (RYGB), biliopancreatic diversion with duodenal switch (BPD-DS), single anastomosis duodenal-ileal bypass with sleeve (SADI-S), one anastomosis gastric bypass (OAGB), and vertical banded gastroplasty (VBG).
Main Results:
- Adjustable gastric band (AGB) shows high weight recurrence, with conversion to RYGB, SG, or BPD-DS as options.
- Revisional sleeve gastrectomy (SG) may involve resleeving or conversion to RYGB.
- Roux-en-Y gastric bypass (RYGB) revisions can include roux limb distalization, pouch resizing, or conversion to BPD-DS.
- Limited data exists for revisional surgery after single anastomosis duodenal-ileal bypass with sleeve (SADI-S).
- One anastomosis gastric bypass (OAGB) and vertical banded gastroplasty (VBG) revisions commonly involve conversion to RYGB.
Conclusions:
- Revisional bariatric surgery is increasingly prevalent.
- The ideal surgical approach is contingent upon the patient's specific indication and pre-existing anatomy.
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