Laparoscopic revision of failed open bariatric procedures

Background: Roux-en-Y gastric bypass (RYGB) is considered the surgical procedure of choice for morbid obesity. Patients who fail to meet weight loss goals after restrictive or malabsorptive surgery can be offered revision. We present five cases in which prior open bariatric procedures were revised laparoscopically. Patients: Five patients presented for laparoscopic revision having regained weight after initial success with prior bariatric surgery. Results: Preoperative body mass index averaged 46 kg/m2. Average operative time was significantly longer (344 min) than we had experienced with 56 primary RYGB during the same 4-month period (206 min). In one patient, a stricture had developed at the gastrojejunostomy requiring endoscopic dilation. There were no other complications and no deaths. All the patients had lost weight at the 6-month follow-up assessment. Conclusions: Laparoscopic revision of failed open bariatric procedures, although requiring longer operative times than primary RYGB, can be performed safely in the hands of an experienced minimally invasive surgeon.