Robot-Assisted Revisional Surgery of Gastric Greater Curvature Plication to Roux-en-Y Gastric Bypass

Background and Objectives: Laparoscopic gastric greater curvature plication (LGGCP) is considered to be less invasive, technically simpler, and less costly. Few studies have compared LGGCP to gastric bypass. The aim of this prospective study was to evaluate the mid-term outcomes of LGGCP such as weight loss, gastrointestinal symptoms, and health-related quality of life (HRQoL) in comparison to laparoscopic Roux-en-Y gastric bypass (LRYGB). Materials and Methods: Between 2017 April and 2018 December, 112 patients were included in the study. Fifty patients had LGGCP, and sixty-two patients underwent LRYGB. Demographics, comorbidities, complications, percentage of excess body mass index loss (%EBMIL), gastrointestinal symptoms (GSRS questionnaire), and HRQoL (EQ-5D-3L questionnaire) were analysed. Gastrointestinal symptoms and HRQoL data are presented as the mean and median with the interquartile range (25th–75th percentile). Follow-up at 1 year and 3 year was performed. Results: The follow-up rate was 96.4% and 92.9%, 1 year and 3 year after surgery, respectively. Mean (SD) %EBMIL 1 year after surgery was 59.05 (25.34) in the LGGCP group and 82.40 (19.03) in the LRYGB group (p < 0.001) and 3 year after was 41.44 (26.74) and 75.59 (19.14), respectively (p < 0.001). The scores of all gastrointestinal symptoms measured by the GSRS questionnaire significantly decreased 3 year after both procedures, except reflux after LGGCP. Patients 3 year after LGGCP had a significantly lower abdominal pain score as compared to patients after LRYGB (1.01; 1.0 (1.0–1.0) and 1.20; 1.0 (1.0–1.33), respectively (p < 0.001); however, LGGCP resulted in significantly more GERD symptoms (1.79; 1.25 (1.0–2.5) and 1.18; 1.0 (1.0–1.0), respectively (p < 0.001)). Three years after surgery, the quality of life was significantly lower in the LGGCP group (0.762; 0.779 (0.690–0.794) and 0.898; 1.000 (0.783–1.000), respectively (p < 0.001)). Conclusions: Three years after surgery, LGGCP patients lost significantly less weight, had less abdominal pain and more reflux symptoms, and a lower quality of life as compared to LRYGB patients.

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A Rare Case of Gastric Volvulus Post Laparoscopic Gastric Greater Curvature Plication

The Surgery Journal ◽

10.1055/s-0040-1701224 ◽

2020 ◽

Vol 06 (01) ◽

pp. e24-e27

Author(s):

Antoine Kachi ◽

Khalil Chidiac ◽

Charif Khaled

Keyword(s):

Weight Loss ◽

Gastric Bypass ◽

Sleeve Gastrectomy ◽

Rare Case ◽

Gastric Volvulus ◽

Atypical Presentation ◽

Rare Entity ◽

Surgery Patient ◽

Greater Curvature ◽

Greater Curvature Plication

AbstractGastric volvulus is a rare entity. Its diagnosis remains tricky and challenging. In recent years, the incidence of gastric volvulus has shown a rise in postbariatric surgery patient. Several cases were reported of gastric remnant volvulus post-laparoscopic sleeve gastrectomy and laparoscopic gastric bypass. Laparoscopic gastric greater curvature plication is a new and experimental restrictive technique for weight loss. Several of its complications were reported in the literature but never was a case of volvulus postgastric plication reported, as far as we know. We present this rare case with an atypical presentation and go through similar cases in the literature.

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Mechanical colon obstruction due to the alimentary limb after Roux-en-Y gastric bypass: a case report

Journal of Medical Case Reports ◽

10.1186/s13256-020-02645-w ◽

2021 ◽

Vol 15 (1) ◽

Author(s):

Caspar Joyce Peterson ◽

Jennifer Klasen ◽

Tarik Delko ◽

Romano Schneider

Keyword(s):

Gastric Bypass ◽

Bowel Obstruction ◽

Transverse Colon ◽

Bypass Surgery ◽

Revisional Surgery ◽

Gastric Bypass Surgery ◽

Morbidly Obese ◽

Tight Closure ◽

Alimentary Limb ◽

Colon Obstruction

Abstract Background Small bowel obstruction is a known and potentially lethal complication after gastric bypass surgery, in both the early and the late postoperative course. Colon or large bowel obstruction, on the other hand, seems to be rare after gastric bypass surgery and thus is not routinely considered. Case presentation We present the case of a 21-year old morbidly obese caucasian patient who underwent laparoscopic Roux-en-Y gastric bypass surgery and developed an early severe transverse colon obstruction due to compression of the transverse colon by the antecolic alimentary limb. Emergency revisional surgery showed a short and tense alimentary limb mesentery and possibly tight closure of Petersen’s space contributing to the compression. Through opening of Petersen’s space and mobilization of alimentary limb mesentery, decompression was achieved, and the patient fully recovered. Conclusions This is a rare case of colon obstruction caused by direct compression of the transverse colon by the antecolic alimentary limb. We propose that a combination of short tense alimentary limb mesentery and perhaps tight closure of Petersen’s space was responsible for the obstruction in this case. Surgeons and treating physicians need to be aware of such rare causes of early postoperative bowel obstruction and take these into consideration when evaluating patients.

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Single Anastomosis Duodenoileal Bypass or Roux-en-Y Gastric Bypass After Failed Sleeve Gastrectomy: Medium-Term Outcomes

Obesity Surgery ◽

10.1007/s11695-021-05609-1 ◽

2021 ◽

Author(s):

Phillip J. Dijkhorst ◽

May Al Nawas ◽

Laura Heusschen ◽

Eric J. Hazebroek ◽

Dingeman J. Swank ◽

...

Keyword(s):

Quality Of Life ◽

Weight Loss ◽

Gastric Bypass ◽

Sleeve Gastrectomy ◽

Revisional Surgery ◽

Complication Rates ◽

Total Weight Loss ◽

Micronutrient Deficiencies ◽

Single Anastomosis

Abstract Background Although the sleeve gastrectomy (SG) has good short-term results, it comes with a significant number of patients requiring revisional surgery because of insufficient weight loss or functional complications. Objective To investigate the effectiveness of the single anastomosis duodenoileal bypass (SADI-S) versus the Roux-en-Y gastric bypass (RYGB) on health outcomes in (morbidly) obese patients who had previously undergone SG, with up to 5 years of follow-up. Methods Data from patients who underwent revisional SADI-S or RYGB after SG were retrospectively compared on indication of surgery, weight loss, quality of life, micronutrient deficiencies, and complications. Results From 2007 to 2017, 141 patients received revisional laparoscopic surgery after SG in three specialized Dutch bariatric hospitals (SADI-S n=63, RYGB n=78). Percentage total weight loss following revisional surgery at 1, 2, 3, 4, and 5 years was 22%, 24%, 22%, 18%, and 15% for SADI-S and 10%, 9%, 7%, 8%, and 2% for RYGB (P<.05 for 1–4 years). Patients who underwent RYGB surgery for functional complications experienced no persistent symptoms of GERD or dysphagia in 88% of cases. No statistical difference was found in longitudinal analysis of change in quality of life scores or cross-sectional analysis of complication rates and micronutrient deficiencies. Conclusion Conversion of SG to SADI-S leads to significantly more total weight loss compared to RYGB surgery with no difference in quality of life scores, complication rates, or micronutrient deficiencies. When GERD in sleeve patients has to be resolved, RYGB provides adequate outcomes. Graphical abstract

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Long-Term Weight Gain after Gastric Bypass: Causes, Characteristics, and Outcomes in Patients Presenting for Revisional Surgery

Journal of the American College of Surgeons ◽

10.1016/j.jamcollsurg.2019.08.900 ◽

2019 ◽

Vol 229 (4) ◽

pp. e70

Author(s):

Julio Teixeira ◽

Dimitar Ranev ◽

Poppy Addison ◽

Filippo Filicori

Keyword(s):

Gastric Bypass ◽

Weight Gain ◽

Revisional Surgery

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Short-Term Results of Single-Anastomosis Gastric Bypass After Failed Sleeve Gastrectomy

QJM ◽

10.1093/qjmed/hcab097.039 ◽

2021 ◽

Vol 114 (Supplement_1) ◽

Author(s):

Alaa Abbas Sabry ◽

Karim Sabry Abd-Elsamee ◽

Mohamed Ibrahim Mohamed ◽

Mohammed Mohamed Ahmed Abd-Elsalam

Keyword(s):

Weight Loss ◽

Gastric Bypass ◽

Sleeve Gastrectomy ◽

Weight Regain ◽

Revisional Surgery ◽

One Anastomosis Gastric Bypass ◽

Short Term ◽

Multicenter Studies ◽

Metabolic Outcomes

Abstract Background It is already known that Laparoscopic sleeve gastrectomy (LSG) has gained popularity as a stand-alone procedure with good short-term results for weight loss. However, in the long-term, weight regain is considered as a complication. Demand for secondary surgery is rising, partly for this reason, but through that study we try to discover the efficacy of conversion of failed sleeve gastrectomy to one anastomosis gastric bypass (OAGB) regarding weight loss and metabolic outcomes. Objective To asses the efficacy and safety of one anastomosis gastric bypass (OAGB) as a conversion surgery post Sleeve Gastrectomy failure as regard weight loss and metabolic outcomes. Patients and Methods This study is a retrospective cohort study which included 20 patients underwent one anastomosis gastric bypass at Ain-Shams University El-Demerdash Hospital, Cairo, Egypt and specialized bariatric center, Cairo, Egypt From February 2019 to July 2019 with 6 months of postoperative follow up till January 2019. Results In this study, we reviewed and analyzed the outcomes from the revision of the SG due to either inadequate weight loss or weight regain to one anastomosis gastric bypass (OAGB) with %EBWL of 6.65% at 1 month, 13.61 % at 3 months and 20.86% at 6 months. Conclusion OAGB appears to be an effective and safe therapeutic technique as a revisional surgery for failed primary SG with good short-term results for treating morbid obesity and its associated comorbidities with a significantly low rate of complications. However the EBWL was less than what is reported after primary OAGB weight. Multicenter studies with larger series of patients and longer term follow up after SG revisions to OAGB are warranted.

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