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Spurzem et al. Mini-invasive Surg. 2025;9:10 Mini-invasive Surgery
DOI: 10.20517/2574-1225.2024.96

Original Article Open Access

Embracing the second chance: efficacy and safety

of revisional bariatric surgery for weight regain

Graham J. Spurzem , Ryan C. Broderick, Estella Y. Huang, Hannah M. Hollandsworth, Bryan J. Sandler,
Garth R. Jacobsen, Santiago Horgan

Department of Surgery, Division of Minimally Invasive Surgery, University of California San Diego, La Jolla, CA 92037, USA.
Correspondence to: Dr. Graham J. Spurzem, Department of Surgery, Division of Minimally Invasive Surgery, University of
California San Diego, 9300 Campus Point Dr., La Jolla, CA 92037, USA. E-mail: gspurzem@health.ucsd.edu

How to cite this article: Spurzem GJ, Broderick RC, Huang EY, Hollandsworth HM, Sandler BJ, Jacobsen GR, Horgan S. Embracing
the second chance: efficacy and safety of revisional bariatric surgery for weight regain. Mini-invasive Surg. 2025;9:10. https://dx.
doi.org/10.20517/2574-1225.2024.96

Received: 18 Nov 2024 First Decision: 24 Feb 2025 Revised: 26 Feb 2025 Accepted: 18 Mar 2025 Published: 20 Mar 2025

Academic Editor: Giulio Belli Copy Editor: Pei-Yun Wang Production Editor: Pei-Yun Wang

Abstract
Aim: Weight recidivism following bariatric surgery has major physical and psychological consequences. Revisional
surgery is a common management option but is associated with increased complications compared to primary
surgery. The objective of this study was to assess the efficacy and safety of revisional bariatric surgery for weight
regain at our institution.

Methods: A retrospective database review identified patients who underwent revisional bariatric surgery for
weight regain at our institution from 2014 to 2023. Emergent operations were excluded. The primary outcomes
were percentage total (%TWL) and excess weight loss (%EWL) using revisional surgery weight as the baseline.
Secondary outcomes were 30-day morbidity, mortality, readmission, and reoperation rates.
Results: Seventy patients were identified. Five types of revisional procedures were performed: 39 (55.7%) Roux-
en-Y gastric bypass (RYGB) revisions (21 endoscopic, 11 laparoscopic, 6 robotic, 1 open), 15 (21.4%) sleeve
gastrectomy (SG) to one-anastomosis gastric bypass (OAGB) conversions (8 robotic, 7 laparoscopic), 8 (11.4%)
SG revisions (7 laparoscopic, 1 robotic), 7 (10.0%) laparoscopic gastric band to SG conversions, and 1 (1.4%)
laparoscopic gastric band to OAGB conversion. SG to OAGB conversion had the largest mean 12-month %EWL at
67.9 ± 25.1, which was significantly greater than SG revision at 47.4 ± 6.7 (P = 0.04) and gastric band to SG
conversion at 44.1 ± 21.1 (P = 0.04). SG to OAGB conversion also had the largest mean 12-month %TWL at 19.1 ±
9.4, significantly greater than RYGB revision at 9.0 ± 6.0 (P < 0.001). The 30-day morbidity rate for all patients
was 7.1% (N = 5), including 1 anastomotic leak following an SG revision requiring 1 reoperation (1.4%). The 30-day

© The Author(s) 2025. Open Access This article is licensed under a Creative Commons Attribution 4.0
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