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Gastric Bypass as a Revisional Procedure

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Minimally Invasive Bariatric Surgery

Abstract

In most experienced bariatric centers, revisional procedures comprise 10% to 15% of the operations performed, most of which are referred from other bariatric surgeons. The need for revisional surgery has been reported in 5% to 36% of patients undergoing vertical banded gastro plasty (VBG) and from 5% to 23% of patients under going Roux-en-Y gastric bypass (RYGBP) (1, 2). This chapter discusses RYGBP as a revisional procedure for failed bariatric procedures. Although the number of revi sional procedures done laparoscopically is very small, there is a growing body of evidence that supports its safety and feasibility (36). Yet, it is important to remem ber that the principles of evaluating failed bariatric pro cedures and the rationale for revisional surgery are not dictated by the method of accessing the abdominal cavity but rather are governed by lessons learned from the cumulative experience of an evidence-based approach and a tertiary, bariatric practice.

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References

  1. MacLean LD, Rhode BM, Samplis J, et al. Results of the surgical treatment of obesity. Am J Surg 1993;165:155–162.

    Article  CAS  PubMed  Google Scholar 

  2. del Almo DA, Diez MM, Guedea ME, Diago VA. Vertical banded gastroplasty: is it a durable operation for morbid obesity? Obes Surg 2004;14:536–538.

    Article  Google Scholar 

  3. McCormick JT, Papasavas PK, Caushaj PF, Gagne DJ. Laparoscopic revision of failed open bariatric procedures. Surg Endosc 2003;17:413–415.

    Article  CAS  PubMed  Google Scholar 

  4. Khaitan L, van Sickle K, Gonzalez R, Lin E, Ramshaw B, Smith CD. Laparoscopic revision of bariatric procedures: Is it feasible? Am Surg 2005;71:6–12.

    PubMed  Google Scholar 

  5. Cohen R, Pinheiro JS, Correa JL, Schiavon C. Laparoscopic revisional bariatric surgery. Myths and facts. Surg Endosc 2005;19:822–825.

    Article  CAS  PubMed  Google Scholar 

  6. de Csepel J, Nahouraii R, Gagner M. Laparoscopic gastric bypass as a reoperative bariatric surgery for failed open restrictive procedures. Surg Endosc 2001;15:393–397.

    Article  PubMed  Google Scholar 

  7. Gonzalez R, Gallagher SF, Haines K, Murr MM. Operative technique for converting a failed vertical banded gastro plasty to Roux-en-Y gastric bypass. J Am Coll Surg 2005; 201:366–374.

    Article  PubMed  Google Scholar 

  8. Behrns KE, Smith CD, Kelly KA, et al. Reoperative bariatric surgery. Lessons learned to improve patient selec tion and results. Ann Surg 1993;218:646–653.

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  9. Moreno P, Alastrué A, Rull M, et al. Band erosion in patients who have undergone vertical banded gastroplasty. Incidence and technical solutions. Arch Surg 1998; 133:189–193.

    Article  CAS  PubMed  Google Scholar 

  10. Murr MM, Gallagher SF. Technical considerations for transabdominal loading of the circular stapler in laparo scopic Roux-en-Y gastric bypass. Am J Surg 2003;185:585–588.

    Article  PubMed  Google Scholar 

  11. Murr MM, Balsiger BM, Kennedy FP, Mai JL, Sarr MG. Malabsorptive procedures for severe obesity: comparison of pancreatico-biliary bypass and very very long Roux-en-Y gastric bypass. J Gastrointest Surg 1999;3:607–612.

    Article  CAS  PubMed  Google Scholar 

  12. Sugerman HJ, Kellum JM Jr, DeMaria EJ, Reines HD. Con version of failed or complicated vertical banded gastro plasty to gastric bypass in morbid obesity. Am J Surg 1996; 171:263–269.

    Article  CAS  PubMed  Google Scholar 

  13. Balsiger BM, Murr MM, Mai J, Sarr MG. Gastroesophageal reflux after intact vertical banded gastroplasty: correction by conversion to Roux-en-Y gastric bypass. J Gastrointest Surg 2000;4:276–281.

    Article  CAS  PubMed  Google Scholar 

  14. Requarth JA, Burchard MD, Collachio TA, et al. Long-term morbidity following jejunoileal bypass: the continuing poten tial need for surgical reversal. Arch Surg1995;130:318–325.

    Article  CAS  PubMed  Google Scholar 

  15. Kirkpatrick JR. Jejunoileal bypass: a legacy of late compli cations. Arch Surg 1987;122:610–614.

    Article  CAS  PubMed  Google Scholar 

  16. Hocking MP, Duerson MC, O’Leary JP, Woodward ER. Jejunoileal bypass for morbid obesity: late follow-up in 100 cases. N Engl J Med 1983;308:995–999.

    Article  CAS  PubMed  Google Scholar 

  17. Dean P, Joshi S, Kaminski DL. Jejunoileal bypass: can the mistake by corrected? Gastroenterology 1990;98:1710–1719.

    Google Scholar 

  18. Våge V, Solhaug JH, Berstad A, et al. Jejunoileal bypass in the treatment of morbid obesity: a 25-year follow-up study of 36 patients. Obes Surg 2002;12:312–318.

    Article  PubMed  Google Scholar 

  19. Frandsen J, Pedersen SB, Richelsen B. Long term follow up of patients who underwent jejunoileal bypass for morbid obesity. Eur J Surg 1998;164:281–286.

    Article  CAS  PubMed  Google Scholar 

  20. Styblo T, Martin S, Kaminski DL. The effects of reversal of jejunoileal bypass operations on hepatic triglyceride content and hepatic morphology. Surgery 1984;96:632–640.

    CAS  PubMed  Google Scholar 

  21. Brown RG, O’Leary JP, Woodward ER. Hepatic effects of jejunoileal bypass for morbid obesity. Am J Surg 1974;127:53–58.

    Article  CAS  PubMed  Google Scholar 

  22. Gonzalez R, Lin E, Venkatesh KR, et al. Gastrojejunostomy during laparoscopic gastric bypass. Analysis of 3 techniques. Arch Surg 2003;138:181–184.

    Article  PubMed  Google Scholar 

  23. van Wageningen B, Berends FJ, van Ramshorst B, Janssen IFM. Revision of failed laparoscopic adjustable gastric banding to Roux-en-Y gastric bypass. Obes Surg 2006;16:137–141.

    Article  PubMed  Google Scholar 

  24. Weber M, Muller MK, Michael JM, Belal R, Horber F, Hauser R, Clavien PA. Laparoscopic Roux-en-Y gastric bypass, but not rebanding, should be proposed as rescue procedure for patients with failed laparoscopic gastric banding. Ann Surg 2003;6:827–834.

    Article  Google Scholar 

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Gonzalez, R., Gallagher, S.F., Sarr, M.G., Murr, M.M. (2007). Gastric Bypass as a Revisional Procedure. In: Schauer, P.R., Schirmer, B.D., Brethauer, S.A. (eds) Minimally Invasive Bariatric Surgery. Springer, New York, NY. https://doi.org/10.1007/978-0-387-68062-0_34

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  • DOI: https://doi.org/10.1007/978-0-387-68062-0_34

  • Publisher Name: Springer, New York, NY

  • Print ISBN: 978-0-387-68058-3

  • Online ISBN: 978-0-387-68062-0

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