Revisional Roux-en-Y gastric bypass after gastric banding leads to sustainable and significant additional weight loss regardless of Roux limb length

Julian Süsstrunk; Liv Zingg; Thomas Köstler; Alexander Wilhelm; Ioannis I Lazaridis; Tarik Delko; Urs Zingg

doi:10.1016/j.amjsurg.2025.116359

Revisional Roux-en-Y gastric bypass after gastric banding leads to sustainable and significant additional weight loss regardless of Roux limb length

Am J Surg. 2025 Jul:245:116359. doi: 10.1016/j.amjsurg.2025.116359. Epub 2025 Apr 23.

Authors

Julian Süsstrunk¹, Liv Zingg², Thomas Köstler³, Alexander Wilhelm⁴, Ioannis I Lazaridis⁵, Tarik Delko⁶, Urs Zingg⁷

Affiliations

¹ Department of Surgery, Obesity & Bariatric Surgery Centre, Limmattal Hospital, 8952, Zurich-Schlieren, Switzerland; Discipline of Surgery, The Queen Elizabeth Hospital, University of Adelaide, Adelaide, South Australia, Australia; Clarunis, Department of Visceral Surgery, University Digestive Health Care Center, St. Clara Hospital and University Hospital Basel, Basel, Switzerland. Electronic address: j.suesstrunk@gmail.com.
² Department of Surgery, Obesity & Bariatric Surgery Centre, Limmattal Hospital, 8952, Zurich-Schlieren, Switzerland. Electronic address: liv.zingg@me.com.
³ Department of Surgery, Obesity & Bariatric Surgery Centre, Limmattal Hospital, 8952, Zurich-Schlieren, Switzerland. Electronic address: thomas.koestler@spital-limmattal.ch.
⁴ Clarunis, Department of Visceral Surgery, University Digestive Health Care Center, St. Clara Hospital and University Hospital Basel, Basel, Switzerland. Electronic address: alexander.wilhelm@clarunis.ch.
⁵ Department of Surgery, Obesity & Bariatric Surgery Centre, Limmattal Hospital, 8952, Zurich-Schlieren, Switzerland. Electronic address: ioannis.lazaridis@spital-limmattal.ch.
⁶ Department of Surgery, Hirslanden Hospital, St. Anna-Strasse 32, 6006, Lucerne, Switzerland. Electronic address: tarik.delko@hin.ch.
⁷ Department of Surgery, Obesity & Bariatric Surgery Centre, Limmattal Hospital, 8952, Zurich-Schlieren, Switzerland. Electronic address: urs.zingg@spital-limmattal.ch.

PMID: 40339207
DOI: 10.1016/j.amjsurg.2025.116359

Abstract

Introduction: The aim of this study is to compare the outcomes between patients undergoing very-very long limb RYGB (VVLL-RYGB) and proximal RYGB (PRYGB) after adjustable gastric banding (LAGB).

Methods: All patients undergoing conversion from LAGB to RYGB in a bariatric reference center between 2010 and 2016 were analyzed.

Results: Sixty-six patients (80 % female, mean age 44.5 ± 9 years, pre-revisional BMI 40.2 ± 7.4 kg/m2) underwent conversion from LAGB to VVLL-RYGB, and 26 patients (88 % female, mean age 46.9 ± 7.6 years, pre-revisional BMI 37.2 ± 5.3 kg/m2) to PRYGB. ΔBMI 5 years after conversion was 8.2 ± 6.1 kg/m2 in VVLL-RYGB compared to 6.7 ± 5.1 kg/m2 in PRYGB (p = 0.35). There was no significant difference in long-term morbidity. Further revisional procedures after VVLL-RYGB occurred in 10 (15.1 %) and 8 (30.8 %) after PRYGB (p = 0.136).

Conclusion: VVLL-RYGB and PRYGB after LAGB are safe and lead to significant and sustainable additional weight loss without difference in BMI loss between the procedures after 5 years.

Keywords: Bariatric surgery; Gastric bypass; Reoperation; Weight loss.

Publication types

Comparative Study

MeSH terms

Adult
Body Mass Index
Female
Gastric Bypass* / methods
Gastroplasty* / methods
Humans
Male
Middle Aged
Obesity, Morbid* / surgery
Reoperation
Retrospective Studies
Treatment Outcome
Weight Loss*