Comparing Revisional Laparoscopic Roux-en-Y Gastric Bypass Versus Ringed Revisional Roux-en-Y Gastric Bypass After Laparoscopic Sleeve Gastrectomy

Summary

Obesity remains a major global health challenge, with rising prevalence and significant metabolic, cardiovascular, and gastrointestinal comorbidities. Laparoscopic sleeve gastrectomy (LSG) has emerged as the most widely performed bariatric procedure due to its technical simplicity and satisfactory short- to mid-term results. However, a proportion of patients experience suboptimal weight loss, recurrent weight gain, or both. In this study, patients with recurrent weight gain of maximum weight loss or suboptimal weight loss or both following sleeve gastrectomy were included. Suboptimal weight loss is defined as total weight loss (TWL) of less than 20% of the preoperative weight and/or excess weight loss (EWL) of less than 50%, measured at least 12-18 months after the primary sleeve gastrectomy. Recurrent weight gain after sleeve gastrectomy is defined as an increase of ≥20% of the maximum weight loss (from nadir weight) or an increase in BMI of \>5, measured at least 24 months after the primary procedure.

Eligibility

Inclusion Criteria:

* Adults aged 18-65 years.
* Patients who experienced recurrent weight gain, suboptimal weight loss, or both within 12-24 months or more following sleeve gastrectomy.
* Eligible and fit for bariatric surgery.
* Willing to provide informed consent and adhere to follow-up.

Exclusion Criteria:

* Severe psychiatric disorders or uncontrolled substance abuse.
* Pregnancy or planned pregnancy within 2 years post-surgery.
* Chronic steroid use or immunosuppressive therapy.
* Active malignancy or history of gastrointestinal cancer.
* Severe cardiac or pulmonary disease precluding surgery.
* Uncontrolled endocrine disorders (other than T2DM).
* Inability to comply with follow-up or protocol requirements.

Conditions2

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