Paper on revisional surgery

Here is an abstract of a recent publication -- it is very interesting to note that "the majority of the patients were not aware of all the surgical procedures available to them at the time of their original operation" -- PLEASE, those of you who are still pre-op, make sure you include the DS in your research: Obes Surg. 2004 Oct;14(9):1187-92. Related Articles, Links Duodenal switch is a safe operation for patients who have failed other bariatric operations. Keshishian A, Zahriya K, Hartoonian T, Ayagian C. Department of Surgery, Delano Regional Medical Center, 1205 Garces Highway, Delano, CA 93215, USA. [email protected] BACKGROUND: The incidence of morbid obesity and its surgical treatment have been increasing over the last few years. With this increase, there has been a rise in the number of patients who have had less than desirable outcome after bariatric operations. We perform the duodenal switch (DS) in patients for whom other weight loss surgical procedures have failed, because of inadequate weight loss, weight regain or significant complications, such as solid intolerance or dumping syndrome. METHOD: From November 1999 to March 2004, 46 revisional surgeries were performed at our institution. The data was prospectively collected and reviewed, based on a number of parameters. Operative details, perioperative morbidity, and results are reported. RESULTS: 46 patients had their original bariatric surgical operation revised to DS. This resulted in complete resolution of their presenting complaints. The %EWL was 69% at the time of publication, with a mean lapsed time of 30 months. We had no mortality. Anastomotic lea****urred in 4 patients, 2 in our first 8 patients. We also noted that the majority of the patients were not aware of all the surgical procedures available to them at the time of their original operation. CONCLUSION: In patients in whom gastroplasty, gastric bypass or both have failed to provide adequate weight loss, or worse have resulted in complications, DS can be performed as a safe revisional operation. The revision of other failed bariatric operations to DS results in both weight loss and resolution of the complications.

Very Interesting and hopeful Diana, Thank you! Michele (who is ready for "the switch")