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Obesity Surgery

, Volume 29, Issue 2, pp 376–386 | Cite as

Outcomes of Reoperation After Laparoscopic Gastric Plication Failure

  • Reza Heidari
  • Mohammad TalebpourEmail author
  • Saeed Soleyman-jahi
  • Atefeh Zeinoddini
  • Ali Sanjari Moghaddam
  • Atieh Talebpour
Original Contributions
  • 67 Downloads

Abstract

Background

Management of failed laparoscopic gastric plication (LGP), defined as weight regain or inadequate weight loss, is a challenging issue.

Methods

This prospective investigation was conducted in individuals with morbid obesity who had undergone LGP from 2000 to 2016. Patients with weight loss failure, weight regain, and regain-prone cases were indicated for reoperation. Re-plication, laparoscopic one anastomosis gastric bypass (LOAGB), and modified jejunoileal bypass were done as revisional surgery.

Results

Revisional surgery was performed in 102 of 124 patients who needed reoperation. Overall, 39 re-plication, 38 LOAGB, and 25 malabsorptive procedures were performed. Re-plication was the shortest surgery and had the shortest length of hospital stay. The percentage of TWL at 6, 12, and 24 months of follow-up was 20.5%, 25%, and 26.8% for re-plication; 20.2%, 27%, and 30.5% for LOAGB; and 22.9%, 28.9%, and 32.6% for the malabsorptive procedure, respectively. In addition, the percentage of EWL at 6, 12, and 24 months of follow-up was 62%, 74.6%, and 79.6% for re-plication; 51.6%, 68.2%, and 75.9% for LOAGB; and 55.4%, 70.1%, and 79.1% for malabsorptive procedure, respectively. In long-term follow-up, according to %TWL, LOAGB and malabsorptive procedure had better outcome compared to re-plication, whereas there was no statistically significant difference in %EWL among the three surgical approaches.

Conclusions

In terms of weight loss, reoperation on failed LGP was completely successful and no treatment failure was reported. All three revisional procedures, including re-plication, LOAGB, and malabsorptive procedure showed promising results and provided substantial weight loss. Since there is little information about the long-term efficacy and safety of revisional surgery on failed LGP, we highly recommend further investigations to confirm our results.

Keywords

Obesity Revisional bariatric surgery Laparoscopic gastric plication Total weight loss Re-plication LOAGB 

Notes

Compliance with Ethical Standards

Conflict of Interest

The authors declare that they have no conflict of interest.

Statement of Informed Consent

Informed consent was obtained from all individual participants included in the study.

The Institutional Review Board of Tehran University of Medical Sciences approved the study protocol.

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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2018

Authors and Affiliations

  1. 1.School of MedicicneTehran University of Medical SciencesTehranIran
  2. 2.Universal Scientific, Educational, and Research Network (USERN)Tehran University of Medical SciencesTehranIran
  3. 3.Ward of Laparoscopy, Department of Surgery, Sina HospitalTehran University of Medical SciencesTehranIran
  4. 4.School of MedicineShahid Beheshti University of Medical SciencesTehranIran

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