Gastric Bypass as Conversion from Abandoned Bariatric Procedures: Gastric Plication, Banding or Pacemaker, Toga or Banded Vertical Gastroplasty. A Video Remix

Introduction: recently, increased numbers of revision bariatric procedures are reported worldwide, especially due to insufficient weight loss or weight regain. Some of former bariatric procedures are currently abandoned or anecdotally used due to long-term failure and increased incidence of revision surgeries needed. Objectives: To evaluate the role of laparoscopic gastric bypass LGBP in the treatment of failure of previous, abandoned bariatric procedures. Methods: A video remix of laparoscopic conversion from gastric banding, gastric plication, gastric pacemaker, TOGA or banded vertical gastroplasty is presented. Patients operated between 1997 and 2010 with different bariatric procedures were converted for weight regain, comorbidities recurrence, unsatisfactory results. Intraoperative difficulties, adhesiolisys, different prosthesis removal, unexpected situations are briefly presented. Results: no conversion and no mortality were recorded. Conversion to LGBP was efficient and safe in all revision procedures, with further weight loss recorded. An important improvement of the patients’ symptoms and satisfaction was achieved 6 months postoperatively, with suspension of medical therapy, maintained one year after intervention.Conclusions: conversion in GBP is actually the best option of treatment in case of weight regain after abandoned, former bariatric procedures.