Matthew J Lyon, MD1, Kamal Heer, MD2, Harish Kumar, MD1. 1University of Queensland, 2Monash University
Introduction: Revision Bariatric Surgery is always considered to be associated with higher complication rates. There is currently controversy in the literature regarding one stage and two stage revisions.
Methods: The present study is ongoing longitudinal prospective analysis of data of revision surgery in a single unit. The revision surgery was offered after initial failed or complicated gastric band, sleeve gastrectomy and roux-en-y gastric bypass(RYGB).
Results: There were Forty-two individuals who had revision bariatric surgery. The age of the cohort of patients ranged from twenty-six to seventy-five years. Thirty-three were females and nine males. All patients who were hypertensive or diabetic at the time of their initial bariatric operation had a relapse of their co-morbidity prior to their revision surgery.
| Band converted to Sleeve Gastrectomy | 23 |
| Band converted to RYGB | 6 |
| Sleeve Gastrectomy converted to RYGB | 4 |
| RYGB to revised RYGB | 2 |
| Band converted to Sleeve Gastrectomy | 4 |
| Band Converted to RYGB | 3 |
The two stage revisions patients had their band removed at another facility, had a compilation from the band itself or did not wish for revision surgery initially. Of the two failed bypasses one had a large pouch and very short limbs. The other had a gastro-gastric fistula and ultra short limbs.
There were no deaths in this study. One patient who underwent one stage revision of a gastric band to bypass had an iatrogenic small bowel injury that required a second operation. Amelioration of diabetes and hypertension was seen in all who had relapsed. Weight loss was good in all patients except for the those undergoing revision from short limbed to long limbed bypass.
Conclusion: There is enough evidence that revision surgery is feasible, and can ameliorate metabolic co-morbidities after failed band and sleeve. Two staged surgery is not necessarily safer compared to one stage revision. In the present study an inadvertent iatrogenic injury occurred in one stage revision group but is not true reflection of increased complications.
Presented at the SAGES 2017 Annual Meeting in Houston, TX.
Abstract ID: 87742
Program Number: P610
Presentation Session: iPoster Session (Non CME)
Presentation Type: Poster