BARIATRIC REVISIONAL SURGERY FOR WEIGHT REGAIN AFTER GASTRIC BYPASS AND SLEEVE GASTRECTOMY: A LITERATURE REVIEW

Abstract

Obesity is a highly prevalent condition associated with comorbidities and mortality. Bariatric surgeries are effective in its management, particularly Roux-en-Y gastric bypass (RYGB) and sleeve gastrectomy (SG). However, in up to 50% of cases, weight regain or therapeutic failure occurs in the medium and long term, requiring revisional surgeries. This study is a literature review based on 16 articles (PubMed and SciELO) following the PRISMA methodology. We evaluated revisional techniques after failure or regain, such as single-anastomosis duodenal-ileal bypass (SADI-S), single-anastomosis gastric bypass (OAGB), and endoscopic transoral outlet reduction (eTOR). Regain stems from factors like stoma dilation in RYGB and lifestyle failures after SG. Malabsorptive techniques like SADI-S promote significant additional weight loss but increase the risk of nutritional deficiencies. OAGB is simpler but has lower efficacy than SADI-S in reversing regain. The eTOR technique is less invasive and effective for initial regain after RYGB. The choice of revisional procedure must be individualized, considering complications and goals. Multidisciplinary follow-up is essential for long-term success. In conclusion, SADI-S and OAGB offer notable benefits for patients requiring greater weight loss and metabolic control after primary surgery failure.