Obes Surg. 2010 Dec;20(12):1627-32.

Revisional vs. primary Roux-en-Y gastric bypass--a case-matched analysis: less weight loss in revisions.

Zingg U, McQuinn A, DiValentino D, Kinsey-Trotman S, Game P, Watson D.

Discipline of Surgery, University of Adelaide, Royal Adelaide Hospital, Adelaide, SA, Australia. [email protected]

Abstract

With the increase in bariatric procedures performed, revisional surgery is now required more frequently. Roux-en-Y gastric bypass (RYGB) is considered to be the gold standard revision procedure. However, data comparing revisional vs. primary RYGB is scarce, and no study has compared non-resectional primary and revisional RYGB in a matched control setting. Analysis of 61 revisional RYGB that were matched one to one with 61 primary RYGB was done. Matching criteria were preoperative body mass index, age, gender, comorbidities and choice of technique (laparoscopic vs. open). After matching, the groups did not differ significantly. Previous bariatric procedures were 13 gastric bands, 36 vertical banded gastroplasties, 10 RYGB and two sleeve gastrectomies. The indication for revisional surgery was insufficient weight loss in 55 and reflux in 6. Intraoperative and surgical morbidity was not different, but medical morbidity was significantly higher in revisional procedures (9.8% vs. 0%, p = 0.031). Patients undergoing revisional RYGB lost less weight in the first two postoperative years compared with patients with primary RYGB (1 month, 14.9% vs. 29.7%, p = 0.004; 3 months, 27.4% vs. 51.9%, p = 0.002; 6 months, 39.4 vs. 70.4%, p < 0.001; 12 months, 58.5% vs. 85.9%, p < 0.001; 24 months, 60.7% vs. 90.0%, p = 0.003). Although revisional RYGB is safe and effective, excess weight loss after revisional RYGB is significantly less than following primary RYGB surgery. Weight loss plateaus after 12 months follow-up.


And these data don't even go out past 24 months -- the study doesn't even address the durability of weight loss, even assuming you believe 90% weight loss for the primary procedures at 24 months.

Revision from a mostly or completely restrictive procedure to another mostly restrictive procedure is POINTLESS!

And the DS is just the cat's meow. Thanks but I choose an RNy. I will succeed with my rny.

Teri

Good luck with that.

Good luck with your malabsorption issues. No long-term data on you guys.

Actually, there's 22 years' of data on us guys. About 3% of us eventually have "significant' issues with malabsorption. It's a risk I'm very glad I took seven years ago.

Oh, stop blinding me with science, Ms. Batt!

So just take your FACTS and DATA and stuff a sock in it. LOL.

Nicolle

Just like you succeeded with the band, huh? Meow.

I don't care if this gets me band.... But what a ***** you are! Yea I failed the band, thanks for pointing that out. To bad that's all I failed at... You fail at being HUMAN< KIND< and COMPASSIONATE!

I failed at the band too. I had it removed in November and am revising to DS this spring. The DS has a higher success rate and I'm not willing to fail a second time. So why not revise to a surgery with a greater success rate? A lot of RNYs fail. I cannot logistically justify revising to a surgery with such a high failure rate.

and as seen by their nasty comments ds'ers aren't happy either.

try this leave me alone!