Laparoscopic Revision Gastric Bypass for Inadequate Initial Weight Loss

Study Overview
=================
Brief Summary
-----------------
The main aim of this study is to analyze and report traditional, patient-centered, and composite intermediate-term outcomes after laparoscopic revision Roux-en-Y gastric bypass surgery for inadequate initial weight loss.

Detailed Description
-----------------
There is lack of standardization of primary and revisional bariatric surgery compounded by a scant long-term outcome data. The treatment of inadequate weight loss, weight recidivism, and most severe technical complications after primary bariatric surgery remains refractory to non-operative treatment. Failure rates have been reported up to 20% and 35% for the morbidly obese (MO) and super obese (SO), respectively at 2 to 3 years after surgery. The indication for further surgical intervention remains controversial, as does what type of revisional procedure, both operative and endoscopic, to recommend. Furthermore, there is no standardization of the limb lengths, pouch size or the use of prosthetic reinforcement. Therefore the approach to these patients must be as individualized as their original operations. We formally analyze our experience with all laparoscopic revisional strategies for Inadequate Initial Weight Loss after failed Roux-en-Y gastric bypass(RYGB).

Official Title
-----------------
Laparoscopic Revision Gastric Bypass for Inadequate Initial Weight Loss After Gastric Bypass: Intermediate Results

Conditions
-----------------
Inadequate Initial Weight Loss, Persistent Clinically Severe Obesity

Participation Criteria
=================
Eligibility Criteria
-----------------
Inclusion Criteria: laparoscopic revisional RYGB for failed RYGB with IIWL or non-responders pattern Exclusion Criteria: failed RYGB with a WR pattern patients with prior major bariatric conversion or esophago-gastric surgeries RYGB patients revised by an open surgical approach RYGB patients who underwent laparoscopic revisional RYGB surgery somewhere else and continue their follow-up care with program missing records and/or unreachable patients with scan information for analysis

Ages Eligible for Study
-----------------
Minimum Age: 18 Years
Maximum Age: 65 Years

Sexes Eligible for Study
-----------------
All

Accepts Healthy Volunteers
-----------------
No

Study Plan
=================
How is the study designed?
-----------------

Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Inadequate initial weight loss after gastric bypass<br> | |

What is the study measuring?
-----------------
Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Weight loss expressed as Body Mass Index and Percentage excess weight loss |  | at the lowest weight loss point and at last follow-up | 
| Comorbidity status |  | throughout follow-up | 
| Health-related Quality of Life (HR-QoL) |  | at last follow-up | 
| Subjective satisfaction |  | at the last follow-up | 
| Morbidity and mortality |  | throughout follow-up | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Failure/success rate |  | at yearly intervals throughout follow-up | 
| Metabolic and nutritional variables |  | throughout follow-up | 

 Terms related to the study
=================
Keywords Provided by Centre Hospitalier Valida
-----------------
Inadequate Initial Weight Loss, Inadequate weight loss, Poor weight loss, Failed gastric bypass, Revision gastric bypass