• Skip to primary navigation
  • Skip to main content
  • Skip to footer

SAGES

Reimagining surgical care for a healthier world

  • Home
    • Search
    • SAGES Home
    • SAGES Foundation Home
  • About
    • Who is SAGES?
    • SAGES Mission Statement
    • Advocacy
    • Strategic Plan, 2020-2023
    • Committees
      • Request to Join a SAGES Committee
      • SAGES Board of Governors
      • Officers and Representatives of the Society
      • Committee Chairs and Co-Chairs
      • Full Committee Rosters
      • SAGES Past Presidents
    • Donate to the SAGES Foundation
    • SAGES Store
    • Awards
      • George Berci Award
      • Pioneer in Surgical Endoscopy
      • Excellence In Clinical Care
      • International Ambassador
      • IRCAD Visiting Fellowship
      • Social Justice and Health Equity
      • Excellence in Community Surgery
      • Distinguished Service
      • Early Career Researcher
      • Researcher in Training
      • Jeff Ponsky Master Educator
      • Excellence in Medical Leadership
      • Barbara Berci Memorial Award
      • Brandeis Scholarship
      • Advocacy Summit
      • RAFT Annual Meeting Abstract Contest and Awards
    • “Unofficial” Logo Products
  • Meetings
    • NBT Innovation Weekend
    • SAGES Annual Meeting
      • 2024 Scientific Session Call For Abstracts
      • 2024 Emerging Technology Call For Abstracts
    • CME Claim Form
    • Industry
      • Advertising Opportunities
      • Exhibit Opportunities
      • Sponsorship Opportunities
    • Future Meetings
    • Related Meetings Calendar
  • Join SAGES!
    • Membership Benefits
    • Membership Applications
      • Active Membership
      • Affiliate Membership
      • Associate Active Membership
      • Candidate Membership
      • International Membership
      • Medical Student Membership
    • Member News
      • Member Spotlight
      • Give the Gift of SAGES Membership
  • Patients
    • Healthy Sooner – Patient Information for Minimally Invasive Surgery
    • Patient Information Brochures
    • Choosing Wisely – An Initiative of the ABIM Foundation
    • All in the Recovery: Colorectal Cancer Alliance
    • Find a SAGES Member
  • Publications
    • SAGES Stories Podcast
    • SAGES Clinical / Practice / Training Guidelines, Statements, and Standards of Practice
    • Patient Information Brochures
    • TAVAC – Technology and Value Assessments
    • Surgical Endoscopy and Other Journal Information
    • SAGES Manuals
    • SCOPE – The SAGES Newsletter
    • COVID-19 Annoucements
    • Troubleshooting Guides
  • Education
    • OpiVoid.org
    • SAGES.TV Video Library
    • Safe Cholecystectomy Program
      • Safe Cholecystectomy Didactic Modules
    • Masters Program
      • SAGES Facebook Program Collaboratives
      • Acute Care Surgery
      • Bariatric
      • Biliary
      • Colorectal
      • Flexible Endoscopy (upper or lower)
      • Foregut
      • Hernia
      • Robotics
    • Educational Opportunities
    • HPB/Solid Organ Program
    • Courses for Residents
      • Advanced Courses
      • Basic Courses
    • Fellows Career Development Course
    • Robotics Fellows Course
    • MIS Fellows Course
    • Facebook Livestreams
    • Free Webinars For Residents
    • SMART Enhanced Recovery Program
    • SAGES OR SAFETY Video
    • SAGES at Cine-Med
      • SAGES Top 21 MIS Procedures
      • SAGES Pearls
      • SAGES Flexible Endoscopy 101
      • SAGES Tips & Tricks of the Top 21
  • Opportunities
    • NEW-Area of Concentrated Training Seal (ACT)-Advanced Flexible Endoscopy
    • SAGES Fellowship Certification for Advanced GI MIS and Comprehensive Flexible Endoscopy
    • Multi-Society Foregut Fellowship Certification
    • SAGES Research Opportunities
    • Fundamentals of Laparoscopic Surgery
    • Fundamentals of Endoscopic Surgery
    • Fundamental Use of Surgical Energy
    • Job Board
    • SAGES Go Global: Global Affairs and Humanitarian Efforts
  • Search
    • Search All SAGES Content
    • Search SAGES Guidelines
    • Search the Video Library
    • Search the Image Library
    • Search the Abstracts Archive
  • OWLS
  • Log In

Comparison of Laparoscopic and Open Revision Roux-en-y Gastric Bypass

Y Assadipour, MD, K Vaziri, MD, J Holzmacher, MD, Richard L Amdur, PhD, Juliet Lee, MD, Paul P Lin, MD. The George Washington University Hospital.

Introduction
Revision Roux-en-Y gastric bypass (RRYGB) is performed in patients who have undergone bariatric surgery, but experienced recidivism or complications which have failed medical management. Traditionally, revisions have been approached in an open fashion given the high risk of anastomotic leak (as high as 20%) and other morbidities. The purpose of this study is to compare outcomes of patients who have undergone laparoscopic and open RRYGB.
Methods
A retrospective review of clinical data from all patients who had undergone RRYGB at a single institution was performed. The data on pre-operative co-morbidities, operative variables, and post-operative outcomes were collected and analyzed using t-test and chi square with Yates’ correction.
Results
Ninety-six RRYGB were performed of which 17 were laparoscopic. There was no significant difference in preoperative comorbidities of gender, age, BMI, diabetes, hypertension, or sleep apnea. Average follow up was 20.3 months. Laparoscopic RRYG was performed with a significantly lower blood loss and a trend towards a shorter operative time, and higher % excess weight loss (%EWL) when compared to open RRYGB. There was no significant difference in surgical morbidity, mortality, ICU days or length of stay between laparoscopic and open RRYGB (Table 1). The anastomotic leak rate for open revisions was 2.5%. There were no leaks in the laparoscopic revision group.
Conclusion
Revision RYGB can be performed safely with an anastomotic leak rate that approximates de novo RYGB. A laparoscopic approach can be performed safely with significantly less blood loss and a trend towards a shorter operative time and greater excess weight loss when compared to open revisions. Long term comparable weight loss was achieved without an effect on morbidity or mortality. Future larger studies may be able to demonstrate a significantly shorter operative times and superior excess weight loss of laparoscopic RRYGB.

Table 1: Outcomes
  OPEN              (n=79)  LAPAROSCOPIC (n=17) p
OR Time (minutes) 206.0 +/- 61.67 n=69 170.8 +/- 60.23 n=10 0.095
Estimated Blood Loss 171.49 +/- 148.52 n=78 56.82 +/- 100.35 n=17 0.004
ICU Stay 0.81 +/- 1.16 n=78 0.93 +/- 1.49 n=15 0.884
Length of Stay 5.56 +/- 3.1 n=78 4.69 +/- 1.92 n=16 0.284
% EWL (12 months) 45.05 +/- 17.36 n=27 62.39 +/- 10.23 n=2 0.179
Mortality 0 0 0
Bleeding 1 0 0.641
MI 1 0 0.641
Leak 2 0 0.507
Wound Infection 3 1 .696
DVT 1 0 0.641
Pneumonia 0 0 0

 

 

View Poster

649

Share this:

  • Twitter
  • Facebook
  • LinkedIn
  • Pinterest
  • WhatsApp
  • Reddit

Related

Hours & Info

11300 West Olympic Blvd, Suite 600
Los Angeles, CA 90064
1-310-437-0544
[email protected]
Monday - Friday
8am to 5pm Pacific Time

Find Us Around the Web!

  • Facebook
  • Twitter
  • YouTube

Important Links

SAGES 2023 Meeting Information

Healthy Sooner: Patient Information

SAGES Guidelines, Statements, & Standards of Practice

SAGES Manuals

 

  • taTME Study Info
  • Foundation
  • SAGES.TV
  • MyCME
  • Educational Activities

Copyright © 2023 Society of American Gastrointestinal and Endoscopic Surgeons