Abstract
Bariatric surgery is the most effective available treatment for obesity, inducing
a significant and durable weight loss, and improving several obesity-associated diseases.
However, as the number of bariatric surgeries performed increases, so does the prevalence
of patients who experience either insufficient weight loss or weight regain, accompanied
by relapse or the emergence of new obesity-related diseases. Endoscopic and surgical
bariatric revisional procedures are used to promote weight loss and improve metabolic
function to address these problems. After a psychological, nutritional, medical, and
anatomical evaluation of the gastrointestinal anatomy has been completed, patient
candidacy to a revisional procedure must be defined. In those patients with insufficient
weight loss or weight regain associated with relapse, the emergence of new obesity-related
diseases, or quality-of-life deterioration, a revisional procedure must be selected.
Although current evidence comes mainly from observational and retrospective studies,
with a limited number of patients and short follow-up times, the available data indicate
that revisional procedures are useful to induce a significant weight loss and/or promote
remission of obesity-associated diseases, albeit an increased risk of surgical and/or
nutritional complications. Thus, careful selection of patients is needed to minimize
risk and maximize the benefit of these procedures.
Keywords
bariatric surgery - weight regain - revisional surgery - interventions
