Faculty Collaboration Database

Bariatric Surgeon Perspective on Revisional Bariatric Surgery (RBS) for Weight Recurrence. Surg Obes Relat Dis 2023 Sep;19(9):972-979

Date

04/16/2023

Pubmed ID

37061437

DOI

10.1016/j.soard.2023.02.027

Scopus ID

2-s2.0-85152552070 (requires institutional sign-in at Scopus site)   5 Citations

Abstract

BACKGROUND: Weight recurrence (WR) after bariatric surgery occurs in nearly 20% of patients. Revisional bariatric surgery (RBS) may benefit this population but remains controversial among surgeons.

OBJECTIVES: Explore surgeon perspectives and practices for patients with WR after primary bariatric surgery (PBS).

SETTING: Web-based survey of bariatric surgeons.

METHODS: A 21-item survey was piloted and posted on social media closed groups (Facebook) utilized by bariatric surgeons. Survey items included demographic information, questions pertaining to the definition of suboptimal and satisfactory response to bariatric surgery, and general questions related to different WR management options.

RESULTS: One hundred ten surgeons from 19 countries responded to the survey. Ninety-eight percent responded that WR was multifactorial, including behavioral and biological factors. Failure of PBS was defined as excess weight loss < 50% by 31.4%, as excess weight loss <25% by 12.8%, and as comorbidity recurrence by 17.4%. Surgeon responses differed significantly by gender (P = .036). 29.4% believed RBS was not successful, while 14.1% were unsure. Nevertheless, 73% reported that they would perform RBS if sufficient evidence of benefit existed. Most frequently performed revisional procedures included conversion of sleeve gastrectomy to Roux-en-Y gastric bypass (RYGB), adjustable gastric band to RYGB, and RYGB revision (21.9% versus 18.2% versus 15.3%, respectively).

CONCLUSIONS: This survey demonstrates significant variability in surgeon perception regarding causes and the effectiveness of RBS. Moreover, they disagree on what constitutes a nonsatisfactory response to PBS and to whom they offer RBS. These findings may relate to limited available clinical evidence on best management options for this patient population. Clinical trials investigating the comparative effectiveness of various treatment options are needed.

Author List

Giannopoulos S, Kapsampelis P, Pokala B, Nault Connors JD, Hilgendorf W, Timsina L, Clapp B, Ghanem O, Kindel TL, Stefanidis D

Author

Tammy Lyn Kindel MD, PhD Associate Professor in the Surgery department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Bariatric Surgery
Gastroplasty
Humans
Obesity, Morbid
Reoperation
Retrospective Studies
Surgeons
Weight Loss