Improvement of Comorbidities after Revisional Robotic Roux-en-Y Gastric Bypass Surgery

Raquel Gonzalez-Heredia, MD, PhD, Lisa Sanchez-Johnsen, PhD, Janine Devicais, Pablo Quadri MD, Enrique Elli, MD, FACS. UIC

Introduction: Bariatric revision surgery is sometimes required due to inadequate or insufficient weight loss, the continuous onset of comorbidities and long-term complications regarding the prior bariatric procedure.  The aim of this study was to examine the remission or improvement of medical comorbidities after revisional RYGB surgery

Material and Methods: This is a retrospective study of patients who underwent a revisional Robotic-assisted Roux-en-Y gastric bypass (RYGB) surgery from January 2008 to June 2014 at the University of Illinois Health and Sciences System.

Results: A total of 32 female patients underwent revisional RYGB revision surgery as a reoperation from adjustable laproscopic gastric band (n=16) or sleeve gastrectomy (n=11) or previous gastric bypass (n=5). Mean BMI was 40±10.6 kg/m². The prevalence of comorbidities was as follows: HTN-43.75%, T2DM-28.1% and DLP-25%.prior the revisional surgery. The mean operative time for the revision was 226 ± 45.3 minutes. Average length of hospitalization was 3 days. No post-operative complications or mortalities were recorded. Of those patients who had a pre-revision surgery medical comorbidity, their comorbidities improved in the following way: 64.2% (9/14) for HTN, 77.8 % (7/9) in T2DM, and 62.5% in DLP. In the patients who underwent revision surgery due to weight loss failure (n=20), the mean excess weight loss (EWL) was 39.2% at 6 months (n=11), 53.8% at 1 year (n=13) and 60.7% at 2 years (n=6).

Conclusions: Revisional RYGB surgery was associated with significant improvements in comorbities and weight loss from pre-revision to post-revision surgery. This study provides initial support for RYGB to be used as a revisional surgery.

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