Practices Concerning Revisional Bariatric Surgery: a Survey of 460 Surgeons
There is currently little evidence available on various aspects of Revisional Bariatric Surgery (RBS) and no published consensus amongst experts. The purpose of this study was to understand variation in practices concerning RBS.
Bariatric surgeons from around the world who perform RBS were invited to participate in a questionnaire-based survey on SurveyMonkey®.
A total of 460 respondents from 62 countries took the survey. For revision after gastric banding, Roux-en-Y gastric bypass (RYGB) (75.5%, n = 345) emerged as the commonest choice followed by sleeve gastrectomy (SG) (56.9%, n = 260) and one anastomosis gastric bypass (OAGB) (37.2%, n = 170). For revision after SG, RYGB (77.7%, n = 355) was the commonest option followed by OAGB (42.45%, n = 194) and re-sleeve (22.32%, n = 102). For revision after RYGB, surgical pouch reduction (49.1%, n = 223), prolongation of bilio-pancreatic limb (30.0%, n = 136), and surgical stoma size reduction (26.43%, n = 120) were the most preferred options. Approximately 90.0% of respondents (n = 406/454) routinely perform an upper gastrointestinal endoscopy before an RBS, and 85.6% (n = 388/453) routinely perform a contrast study. Ninety percent (n = 403/445) reported that the demand for RBS was usually patient-driven, and there was wide variation in criteria used to define successful response, non-responders, and significant weight regain.
This survey is the first attempt to understand various aspects of RBS. The findings will help in identifying areas for research and allow consensus building amongst experts.
KeywordsRevisional bariatric surgery Roux-en-Y gastric bypass Sleeve gastrectomy One anastomosis gastric bypass Gastric banding
revisional bariatric surgery
Roux-en-Y gastric bypass
one anastomosis (mini) gastric bypass
adjustable gastric banding
single anastomosis duodeno-ileal bypass with sleeve gastrectomy
bilio-pancreatic diversion/duodenal switch
primary bariatric surgery
excess weight loss
total weight loss
KM conceived the idea for the topic, conducted the survey, and wrote most of the manuscript. All authors critically reviewed the manuscript and helped with writing it. All authors have seen the final version and approve of it.
Compliance with Ethical Standards
Conflict of Interest
The authors declare that they have no conflict of interest.
- 9.Welbourn R, Small P, Finlay, I, Sarela A, Somers S, Mahawar K. Second National Bariatric Surgery Report. http://www.bomss.org.uk/wp-content/uploads/2014/04/Extract_from_the_NBSR_2014_Report.pdf Last Accessed on 22nd August’ 2015Google Scholar
- 12.Almalki OM, Lee WJ, Chen JC, Ser KH, Lee YC, Chen SC. Revisional gastric bypass for failed restrictive procedures: comparison of single-anastomosis (mini-) and roux-en-Y gastric bypass. Obes Surg 2017. doi: https://doi.org/10.1007/s11695-017-2991-0
- 20.No Authors Listed. NICE Guideline CG189. Obesity: identification, assessment and management of overweight and obesity in children, young people and adults (CG189). http://www.nice.org.uk/guidance/cg189/resources/guidance-obesity-identification-assessment-and-management-of-overweight-and-obesity-in-children-young-people-and-adults-pdf. Last accessed on 4th January’2018
- 21.Grundy SM, Barondess JA, Bellegie NJ, Fromm H, Greenway H, Halsted CH et al. Consensus Development Panel. Gastrointestinal surgery for severe obesity. National Institute of Health. Consensus Development Conference Statement. March 25–27, 1991. https://consensus.nih.gov/1991/1991GISurgeryObesity084PDF.pdf Last accessed on 4th January’ 2018