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22-year experience with bariatric revision surgery; What have we learned?
Natasha A Sioda1, Valerie L Armstrong1, Grace Madura1
1Department of General Surgery, Division of Minimally Invasive and Bariatric Surgery Mayo Clinic Arizona, 5777 East Mayo Blvd, Phoenix, AZ, 85054, USA.
American Journal of Surgery
|November 29, 2025
Summary
Bariatric revisions are increasing, with sleeve gastrectomy now most common. Most revisions are for weight regain, often converting to Roux-en-Y gastric bypass for better outcomes.
Area of Science:
- Bariatric Surgery
- Surgical Outcomes
- Obesity Management
Background:
- Rising obesity rates drive increased bariatric surgery procedures in the US.
- Analysis of trends and indications for revisional bariatric surgery is crucial.
Purpose of the Study:
- To analyze trends in revisional bariatric surgery.
- To identify common indications for bariatric revisions.
- To evaluate outcomes of revision procedures.
Main Methods:
- Retrospective review of patients undergoing revisional bariatric surgery.
- Data collected from a multi-site single institution.
- Study period: 2000–2022 with a mean follow-up of 2.6 years.
Main Results:
- 901 patients underwent revision; primary operations included Roux-en-Y gastric bypass (RYGB), gastric banding, and sleeve gastrectomy (SG).
- Sleeve gastrectomy (SG) is now the most frequent primary operation requiring revision.
- Weight regain or inadequate weight loss were the primary indications for revision.
Conclusions:
- Bariatric revision trends correlate with primary procedure popularity and outcomes.
- Revision to RYGB is common and demonstrated significant improvements in outcomes.
- SG is increasingly the most common procedure necessitating revision.
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