Revisional or Conversion Procedures for Roux-en-Y Gastric Bypass Failure

Surgery for morbid obesity has been carried out since 1950s, but it was only after the introduction of biliopancreatic diversion by Scopinaro that the surgical approach to obesity gain worldwide consensus and diffusion [1, 2]. During the years, gastric restrictive procedures, malabsorptive or combined procedures were introduced in the bariatric surgical praxis [3, 4]. Several experiences reported risk and benefit of each procedure, and the even increasing number of operated patients run parallel with a similar increase of re-do operations [5, 6]. Re-do bariatric surgical procedures are mainly indicated for two reasons. The first reason is the presence of an acute or chronic complication or a side effect of the primary bariatric procedure or metabolic and nutritional sequel. The second is the absence of postoperative weight loss or the weight regain after a successful period, untreatable with conservative approach [7–11]. Re-do bariatric procedures can be divided into conversions and revisions. Conversion surgery is defined as the exchange of a bariatric procedure to another one. Revision surgery is defined as the modification of the primary bariatric procedure without changes of its anatomical scheme.