Revision Banded Gastric Bypass

As in many other types of revision surgery, the level of complications is higher in Revision Banded Gastric Bypass compared to primary surgery, yet still quite limited in number and severity.

The most common band related complications are dysphagia, erosion and migration. Valk et al. [12] found 3% of dysphagia requiring band removal or replacement of the gastric ring. It is essential to choose a ring that leaves at least 5mm of space between the pouch and the ring and when necessary, the pouch should be partially resected.

The migration rate was at a level of 1,5% in his study of 74 patients, which also showed 2 patients with gastric perforation within the first 3 days after the operation. These unfortunate cases took place in the first cohort of 10 patients, did not occur anymore after that and can be regarded as part of the learning curve.

Banded bypass as a revision procedure has also been associated with erosion rates of 5,5%. (Fobi [5]), but it needs to be noted that the circumference of the gastric rings used was considerably smaller than the ones used today for revision surgery (7,0 – 8,0cm circumference).

The level of erosions seem to be higher for mesh materials: Revision with pericardial patch ring after gastric bypass for weight regain or failure of weight loss may not be feasible, safe and effective (Moon [16])


Banding the bypass in revision surgery has a slightly higher erosion rate than in primary surgery, but this disadvantage is largely outweighed by the renewed and long lasting weight loss induced by the restriction the banded pouch provides.

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