Outcomes of simultaneous endoscopic transoral outlet reduction and gastric bypass distalization for the management of weight loss failure after Roux-en-Y gastric bypass
- 13.06.2025
- 2025 SAGES Oral
Erschienen in:
- Verfasst von
- Jorge Cornejo
- Agustina A Pontecorvo
- Dilhana Badurdeen
- Victoria Gomez
- Vivek Kumbhari
- Enrique F. Elli
- Erschienen in
- Surgical Endoscopy | Ausgabe 7/2025
Abstract
Background
There are numerous revisional surgery options for weight loss failure after Roux-en-Y Gastric Bypass. To date, there are no studies that assess the weight loss outcomes of single-stage endoscopic revision of the gastrojejunostomy (GJ) (TORe) in biliopancreatic (BP) limb distalization. We aimed to report our experience with single-stage TORe and distalization.
Methods
Sixteen patients (5 TORe and distalization, 6 TORe alone, 5 distalization alone) from 2021 to 2023 were included and retrospectively reviewed. The minimum follow-up time was 24 months. The alimentary limb was distalized to allow for a total common channel length of about 150 cm and the endoscopic suturing was used to bring the diameter of the GJ between 10 and 20 mm.
Results
The average preoperative BMI was 44.25 ± 8.8 kg/m2 with an average excess body weight of 54.16 ± 23.6 kg. The mean operative time for patients who had distalization with and without TORe was 128.4 ± 30.3 min. The mean total alimentary limb length (TALL) was 300 + 45.6 cm. Single-stage TORe and distalization showed higher mean %TWL (23.67 vs 19.92 vs 15.02) and %EWL (37.20 vs 30.72 vs 27) compared to TORe and distalization alone at 24-month follow-up, respectively. One patient required distalization reversal due to malnutrition. The rest of patients who underwent distalization showed minor nutritional deficiencies (Hemoglobin, Hematocrit, Vitamin A, and Copper) at the last follow-up. Preoperative comorbidities were reduced by 33.2%.
Conclusions
Endoscopic and surgical techniques for the management of weight loss failure after Roux-en-Y Gastric Bypass seem to be safe and effective. Single-stage TORe and distalization showed higher weight loss at 24-month follow-up.
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- Titel
- Outcomes of simultaneous endoscopic transoral outlet reduction and gastric bypass distalization for the management of weight loss failure after Roux-en-Y gastric bypass
- Verfasst von
-
Jorge Cornejo
Agustina A Pontecorvo
Dilhana Badurdeen
Victoria Gomez
Vivek Kumbhari
Enrique F. Elli
- Publikationsdatum
- 13.06.2025
- Verlag
- Springer US
- Erschienen in
-
Surgical Endoscopy / Ausgabe 7/2025
Print ISSN: 0930-2794
Elektronische ISSN: 1432-2218 - DOI
- https://doi.org/10.1007/s00464-025-11846-7
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