Obesity is a chronic disease that requires lifelong treatment, although bariatric surgery is a long-lasting and highly effective therapy, as with many other chronic diseases that require medical or surgical therapy, there will be patients who respond well to initial therapy and others with only a partial response, this group of bariatric patients may benefit from additional surgical treatment to treat their obesity or its complications after primary surgery.
The main indications for the revision of bariatric procedures are inadequate weight loss, weight regain, early or late complications specific to each procedure, poor metabolic control of comorbidities.
Revision surgery is classified as:
Conversion:
They are changes to a different type of bariatric procedure, modifying the anatomy of the primary procedure.
Correction:
They are the treatment of complications or improvements of the primary surgical procedure without modifying the anatomy of the primary procedure.
Reversion:
They are operations to restore normal gastrointestinal anatomy.
The main indications for the revision of bariatric procedures are inadequate weight loss, weight regain, early or late complications specific to each procedure, poor metabolic control of comorbidities.
The revision surgery rate varies according to the primary procedure, thus in Roux-en-Y gastric bypass the revision rate is 7.5%, gastric sleeve 9.8%, anastomosis bypass 2.69%, gastric band 40- 60%.
Revision bariatric procedures represent a challenge for both patients and surgeons, currently revision surgery represents the fourth most performed procedure worldwide.