The Effectiveness and Feasibility of Laparoscopic Re-sleeve Gastrectomy.

Background: Weight regain following laparoscopic sleeve gastrectomy (LSG) may be due to dilation of the gastric reservoir. Laparoscopic re-sleeve gastrectomy (LrSG) is among the revisional surgery options.

Objectives: We aimed to investigate the effectiveness of LrSG for weight loss after a 12- and 24-month follow-up period.

Setting: Bariatric surgery center in Baku/Azerbaijan.

Method: From June 2016 to June 2019, a total of 34 LSG patients with weight regain, underwent LrSG. We prospectively followed outcomes data were BMI changes, excessive weight loss, changes in laboratory values, and the presence of complications.

Results: The mean age at revision surgery was 36 ± 7.09 (range, 22-51) years, and the mean body mass index (BMI) before LrSG was 40 ± 5.2 kg/m. The mean time between the primary and revision surgery was 50 ± 7.8 months. The main reasons for the revisions were weight regain and inadequate weight loss. The mean BMI value decrease at the 12th and 24th months were 27.7 ± 2 and 24.3 ± 1.02, which were statistically significant (p < 0.05). Analyses of hemoglobin A1C (A1C) values showed that the differences at the baseline, 12th and 24th months were statistically significant (95% 1.96 to 3.39, p < 0.001 and 95% CI 0.34 to 2.08, p = 0.005, respectively).

Conclusions: In patients with weight regain or inadequate weight loss after LSG, LrSG may be a feasible and safe revisional procedure in a selected group of patients. Larger studies that compare other revisional surgery options (LRYGB, OAGB, duodenal switch, single anastomosis duodeno-ileal bypass) with LrSG are required.