Revision procedures in bariatric surgery

Searching the optimal options for reoperations in overweight patients has the same lengthy and difficult history as all bariatric surgery. The key issues of this aspect of obesity surgery are inefficiency (inadequate weight reduction or it regain) and the unavoidable complications of conservative methods and the negative effects of primary surgery. Weight regain after bariatric surgery is a multicomponent problem. The main reason for the unsatisfactory results of surgical (and conservative) treatment of obesity in some patients is the nature of obesity – the lifelong chronic recurrent disease. A certain role in the return of excess weight is played by the imperfection of the currently existing surgical procedures for the correction of overweight, as well as the wrong choice of options for surgical interventions and technical errors in their implementation. Increase the number of worldwide operations for obesity and its associated diseases translates the problem of revision bariatric surgery from the category of narrow questions in this field of medicine into a serious problem. The article describes modern approaches to the surgical treatment of re-gaining weight after bariatric operations. It considered options for audit procedures, depending on the previously performed surgery. Original techniques of repeated operations for effective correction of the relapse of overweight are described in article.

Gastric volvulus post sleeve gastrectomy converted to gastric bypass in pregnancy: a case report

Complications arising from revision bariatric surgery can be complex due to altered anatomy. This is especially the case in a bariatric patient who becomes pregnant. I present an interesting case of a female patient who suffered a gastric volvulus during pregnancy after having had revision gastric bypass surgery 3 years prior, secondary to an internal hernia. This case highlights that revision bariatric surgery attracts a higher rate of complication, both preoperatively and long term, as well as highlighting the need for a high degree of suspicion for rare causes of abdominal pain in patients post bariatric surgery. Pregnancy is also an added risk factor for these patients.