ONE ANASTOMOSIS GASTRIC BYPASS AS A SALVAGE MANAGEMENT FOR WEIGHT REGAIN AFTER VERTICAL BANDED GASTROPLASTY; SINGLE INSTITUTE EXPERIENCE

Background: Vertical banded gastroplasty (VBG) was a popular bariatric operation two decades ago, but it has been discontinued as it necessitates laparotomy in most cases, and there is often a high incidence of weight regain or insufficient weight loss requiring a revisional bariatric procedure. Objective: The aim of the present study was to evaluate one anastomosis gastric bypass (OAGB) as a relatively safe and less demanding solution for the management of weight regain after VBG. Methods: Between February 2014 and September 2017, 42 morbidly obese patients, who had undergone open VBG and suffered from inadequate weight loss or progressive weight regain, were offered laparoscopic OAGB as a revisional surgery. They completed a follow up for at least one year. Results: All cases were completed laparoscopically. The mean operative time was 166.7?44.6 minutes and the mean hospital stay was 2.2?0.5 days. The mean BMI before revisional surgery was 47.9?6.6 kg/m2, and after one year of follow up it was 29.2?4.9 kg/m2. The mean %EBMIL was 54.3?11.1% at 6 months after surgery and 85.6?16.2% at one year after surgery, with improvement of comorbidities observed in most cases. Conclusion: Laparoscopic OAGB is a safe revisional bariatric option for failed VBG with very successful results in terms of weight reduction, improvement of comorbidities, and low incidence of major complications.