AB057. SOH21AS202. Revisional bariatric surgery: an escalation in surgical management of obesity

Background: Revisional bariatric surgery (RBS) is considered to be higher risk and may confer less benefit compared to primary bariatric surgery (PBS). The aim of this study was to assess perioperative and weight loss outcomes of RBS in an Irish bariatric patient cohort.

Methods: Data on consecutive revisional bariatric procedures was prospectively recorded and reviewed retrospectively. Data collected included demographic details, perioperative and weight loss outcomes.

Results: A total of 25 revisional bariatric procedures occurred in a 39-month period. Twenty-one patients underwent a second bariatric procedure, with two patients undergoing a second and subsequently third bariatric procedure. The primary bariatric procedures were gastric banding (n=13, 56.5%), sleeve gastrectomy (N=9, 39.1%), gastric bypass (N=1, 4.35%). The most common indications for RBS included weight regain (60%, N=15), gastric band slippage (28%, N=7) and severe reflux symptoms (20%, N=5). The majority of RBS patients were female (N=20, 80%). The mean (± SD) age at time of surgery was 46.28±8.50 years old (range, 34–62), mean (± SD) preoperative weight was 126.86 kg ±31.05 and mean preoperative BMI 44.21 kg/m² ±8.77 kg. The revisional bariatric procedures were sleeve gastrectomy (N=5, 20%), roux-en-Y gastric bypass (n=7, 28%) and one-anastomosis gastric bypass (n=13, 52%). There was no mortality recorded in this series. Overall postoperative morbidity rate was 16% (n=4). The 30-day readmission and reoperation rates were both 4%. Total body weight lost (TBWL) at 12-months postoperatively was 19.36%.

Conclusions: RBS is a safe and beneficial intervention for patients who regain weight or develop complications after PBS.

Keywords: Bariatric surgery; gastric bypass; sleeve gastrectomy; revisional bariatric surgery (RBS); weight loss