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Revisional Surgery After Failed Laparoscopic Sleeve Gastrectomy: Retrospective Analysis of Causes, Results, and Technical Considerations

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Abstract

Background

A failed laparoscopic sleeve gastrectomy (LSG) presents a challenging problem for bariatric surgeons. The aim of this study was to evaluate the indications, treatment strategies, and surgical outcomes of patients who underwent a revisional surgery after a failed LSG.

Methods

This retrospective study included the outcomes of 32 patients who required a revisional surgery from a series of 500 primary LSGs. The patients’ demographic data, indications for revisional surgery, perioperative complications, and postoperative outcomes were recorded.

Results

A total of 500 patients underwent primary LSGs during the study period, and 32 of these patients were subjected to revisional bariatric surgery after a failed LSG. Weight regain, poor weight loss, and gastroesophageal reflux disease (GERD) were the most common causes of revision. A revisional LSG (r-LSG) was performed in 23 patients, while 9 patients received a revisional laparoscopic Roux-en-Y gastric bypass (r-LRYGB). There were complete sleeve pouch dilations in 10 patients. A residual fundus and antrum dilation was detected in 5 and 8 patients, respectively. The r-LRYGB procedure was performed for GERD-related symptoms in 6 patients and 3 other patients underwent r-LRYGB due to the intake of high-caloric foods. The mean operative time, length of hospital stay, and complication rates of revisional surgeries were significantly higher than the total cohort.

Conclusions

Although r-LSG and r-LRYGB seem to be safe and effective treatment options after a failed LSG, revisional procedures were associated with an increased complication rate. Attention to technical details of the primary LSG may reduce the revision requirements.

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Authors and Affiliations

  1. Department of Surgery, Faculty of Medicine, Selcuk University, 42075, Konya, Turkey

    Huseyin Yilmaz, Ilhan Ece & Mustafa Sahin

Authors
  1. Huseyin Yilmaz
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  2. Ilhan Ece
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  3. Mustafa Sahin
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Corresponding author

Correspondence to Ilhan Ece.

Ethics declarations

The study was approved by the local ethics committee.

Conflict of Interest

The authors declare that they have no competing interests.

Statement of Informed Consent

The need for patient informed consent for this retrospective study was waived by the institutional review board.

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Yilmaz, H., Ece, I. & Sahin, M. Revisional Surgery After Failed Laparoscopic Sleeve Gastrectomy: Retrospective Analysis of Causes, Results, and Technical Considerations. OBES SURG 27, 2855–2860 (2017). https://doi.org/10.1007/s11695-017-2712-8

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  • DOI: https://doi.org/10.1007/s11695-017-2712-8

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