Background

Over the last few years, revisional bariatric surgery (RBS) rates have increased up to 20%. This study aims to determine whether the primary bariatric procedure or the indications for robotic RBS influence postoperative outcomes.

Methods

Initially, the patient-related characteristics and postoperative outcomes for the primary bariatric procedure and the indication of revisional procedure were individually analyzed. Then, a logistic regression analysis was performed using the primary procedure and the indication of RBS as covariates to identify which was an independent predictor factor for peri- and postoperative outcomes.

Results

In the initial analyses, conversion from SG to RYGB as a primary bariatric procedure and reflux as an indication of revisional BS showed worse postoperative outcomes. Consequently, these two variables were used in the logistic regression analysis for postoperative outcomes, in which patients undergoing LSG were 4.15 times more likely to present early complications (p=0.03, 95% CI: 1.07-16.06) and to present an incomplete resolution of GERD (p=0.01, 95% CI: 0.05-0.68). Patients with reflux as an indication of RBS were 7.76 times more likely to have a TBWL < 25% at 12 months (p=0.01, 95% CI 1,42-42.43) after surgery. 

Conclusions

LSG was an independent predictor for early complications and incomplete resolution of GERD after RBS, meanwhile, reflux was an independent factor for lower TBWL at 12 months.