Practices Concerning Revisional Bariatric Surgery: a Survey of 460 Surgeons

  • Kamal K. Mahawar
  • Abdelrahman Nimeri
  • Marco Adamo
  • Cynthia-Michelle Borg
  • Rishi Singhal
  • Omar Khan
  • Peter K. Small
Original Contributions

Abstract

Background

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.

Methods

Bariatric surgeons from around the world who perform RBS were invited to participate in a questionnaire-based survey on SurveyMonkey®.

Results

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.

Conclusions

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.

Keywords

Revisional bariatric surgery Roux-en-Y gastric bypass Sleeve gastrectomy One anastomosis gastric bypass Gastric banding 

Abbreviations

RBS

revisional bariatric surgery

RYGB

Roux-en-Y gastric bypass

SG

sleeve gastrectomy

OAGB

one anastomosis (mini) gastric bypass

AGB

adjustable gastric banding

SADI-S

single anastomosis duodeno-ileal bypass with sleeve gastrectomy

BPD/DS

bilio-pancreatic diversion/duodenal switch

PBS

primary bariatric surgery

EWL

excess weight loss

TWL

total weight loss

Notes

Author Contribution

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.

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Copyright information

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

Authors and Affiliations

  1. 1.Bariatric UnitSunderland Royal HospitalSunderlandUK
  2. 2.Sheikh Khalifa Medical CityAbu DhabiUAE
  3. 3.University College London Hospitals NHS TrustLondonUK
  4. 4.Lewisham and Greenwich NHS TrustUniversity Hospital LewishamLondonUK
  5. 5.Birmingham Heartlands HospitalBirminghamUK
  6. 6.St. Georges HospitalLondonUK

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