Revisional Surgery After Failed Laparoscopic Sleeve Gastrectomy: Weight Loss and Improvement of Comorbidities

Purpose: This study aims to investigate the causes, outcomes, complications, and sustainable lifestyle changes of revision surgery performed after laparoscopic sleeve gastrectomy (LSG).Methods: This retrospective study included the outcomes of 30 patients who required a revisional surgery from a series of 538 primary LSGs. Demographic data of the patients, indications for revision surgery, complications, postoperative outcomes, and changes in lifestyle were recorded. Postoperative outcomes were analyzed over five periods.Results: In total, 18/30 patients (60.0%) underwent revision surgery for weight gain. Of the revision procedures, 53.3% were one anastomosis gastric bypass (OAGB), 33.3% were revisional sleeve gastrectomy (R-SG), and 13.3% were biliopancreatic diversion (BPD). Weight loss in patients after primary surgery was higher than the weight loss after revision surgery. However, while 43.20% of the total weight loss after primary surgery was recovered, only 23.54% was recovered after revision surgery. Except for obstructive sleep apnea syndrome, improvement in comorbidities was similar in primary surgery and revision surgery.Conclusions: Although revision surgery achieves lower weight loss than primary surgery, revision surgery is more successful in maintaining weight over time, and it has a limited effect on comorbidities.