Our Summary

This research paper is about two types of revisional surgeries that are done after an initial weight loss surgery called sleeve gastrectomy doesn’t work as expected. The two types of revisional surgeries being compared are one-anastomosis gastric bypass (OAGB) and Roux-en-Y gastric bypass (RYGB).

The researchers analyzed previous studies that included 499 people who had these types of revisional surgeries. They found that people who had the OAGB surgery lost more weight compared to those who had the RYGB surgery. The rate of early complications was similar for both types of surgeries.

However, the researchers caution that the data from the studies they analyzed were limited and varied, so they couldn’t draw definitive conclusions. But based on the data they did have, they suggest that OAGB may be a better option for weight loss after initial sleeve gastrectomy.

FAQs

  1. What is the ideal procedure for revisional bariatric surgery after sleeve gastrectomy?
  2. How does the total weight loss compare between one-anastomosis gastric bypass and Roux-en-Y gastric bypass as revisional procedures?
  3. Are the early complication rates similar between one-anastomosis gastric bypass and Roux-en-Y gastric bypass as revisional surgeries?

Doctor’s Tip

A helpful tip a doctor might tell a patient about gastric bypass is to carefully consider the type of revisional procedure to choose if their initial surgery, such as sleeve gastrectomy, fails. Based on current evidence, one-anastomosis gastric bypass (OAGB) may result in better total weight loss compared to Roux-en-Y gastric bypass (RYGB) as a revisional procedure. It is important to discuss all options with your healthcare provider to determine the best course of action for your individual needs and goals.

Suitable For

Patients who are typically recommended for gastric bypass surgery include those who have a body mass index (BMI) of 40 or higher, or a BMI of 35 or higher with obesity-related health conditions such as type 2 diabetes or high blood pressure. Additionally, patients who have not been successful with non-surgical weight loss methods such as diet and exercise may also be recommended for gastric bypass surgery. Revisional bariatric surgery, such as one-anastomosis gastric bypass (OAGB) or Roux-en-Y gastric bypass (RYGB), may be recommended for patients who have experienced weight regain or other complications after a previous bariatric procedure, such as sleeve gastrectomy.

Timeline

Before gastric bypass:

  • Patient undergoes initial evaluation by a healthcare provider to determine if they are a candidate for gastric bypass surgery
  • Patient meets with a bariatric surgeon to discuss the procedure, risks, benefits, and expectations
  • Patient undergoes pre-operative testing and preparation, which may include dietary changes, exercise, and counseling
  • Patient undergoes gastric bypass surgery, which typically involves dividing the stomach into a small upper pouch and a larger lower pouch, and rerouting the small intestine to connect to both pouches

After gastric bypass:

  • Patient is closely monitored in the hospital for a few days post-surgery to ensure proper healing and recovery
  • Patient is instructed on post-operative care, including dietary guidelines, exercise recommendations, and monitoring for potential complications
  • Patient undergoes regular follow-up appointments with their healthcare provider to monitor weight loss progress, nutritional status, and overall health
  • Patient may experience significant weight loss in the weeks and months following surgery, leading to improvements in overall health and quality of life
  • Patient may need additional support and resources, such as counseling or support groups, to help adjust to the physical and emotional changes that come with significant weight loss

Overall, gastric bypass surgery is a life-changing procedure that can lead to significant weight loss and improvements in overall health for many patients. However, it is important for patients to be fully informed and prepared for the challenges and changes that come with this type of surgery.

What to Ask Your Doctor

  1. What are the potential risks and complications associated with gastric bypass surgery as a revisional procedure?
  2. How does one-anastomosis gastric bypass (OAGB) compare to Roux-en-Y gastric bypass (RYGB) in terms of weight loss outcomes for patients who have had a failed sleeve gastrectomy?
  3. What is the expected recovery time and post-operative care plan for gastric bypass surgery as a revisional procedure?
  4. How will my diet and nutrition needs change after gastric bypass surgery as a revisional procedure?
  5. What are the long-term success rates and potential complications of gastric bypass surgery as a revisional procedure for failed sleeve gastrectomy?

Reference

Authors: Dantas ACB, Branco LT, Tustumi F, de Oliveira DRCF, Pajecki D, Santo MA. Journal: Obes Surg. 2022 Dec;32(12):4082-4088. doi: 10.1007/s11695-022-06326-z. Epub 2022 Oct 19. PMID: 36261630