Laparoscopic revisional bariatric surgery - Myths and facts

Background: Bariatric surgery is growing worldwide. An increasing number of patients will require revisional procedures because of inadequate weight control, complications, or loss of quality of life. Methods: From August 1999 to September 2003, 62 patients were submitted to laparoscopic revisional surgery. Results: The primary operations consisted of laparoscopic adjustable gastric banding in 39 cases, banded and nonbanded Roux-en-Y gastric bypass (RYGB) in 17 cases, vertical banded gastroplasty in 4 cases, and biliopancreatic diversion in 2 cases. Although technically demanding, laparoscopic conversion to RYGB was possible in all cases. Mean operative time was 100 min. Mean hospital stay was 77 h. There were no intraoperative or postoperative complications. A good body mass index reduction after the revisional procedure was observed with a 24 month follow-up period. Conclusions: Laparoscopic revisional bariatric surgery is safe and effective. However, it should be performed only by experienced bariatric and laparoscopic surgeons.