Laparoscopic Re-sleeve Gastrectomy: Effectiveness and Possibility

The present study hypothesized (H0) that the decrease in the postoperative 12th and 24th months, body mass index (BMI) values would be significantly lower than the admittance values of LrSG patients. The gastric reservoir may enlarge during laparoscopic sleeve gastrectomy (LSG), which could lead to weight gain. One alternative for revisional surgery is laparoscopic re-sleeve gastrectomy (LrSG).

The study was carried out in Bariatric surgery center in Baku/Azerbaijan 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.

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/m2. 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). Gastric bypass and LSG have similar effects on inducing type 2 diabetes mellitus remission, and DS has been reported to cause best results in this respect. Our data show that before the revision surgery, the frequency of hypertension and diabetes mellitus was 50% and 22.7%.

In a particular patient population, LrSG may be a workable and safe revisional technique for patients who experienced weight increase or insufficient weight loss after LSG. It is necessary to conduct larger research comparing LrSG to other revisional surgical options (LRYGB, OAGB, duodenal switch, single anastomosis duodeno-ileal bypass).