IBC Oxford University Oral Abstract 4 - The impact of abdominoplasties in patients with prior sleeve gastrectomy on de novo GERD and the need for conversion to Roux-en-Y gastric bypass

Abstract Introduction The sleeve gastrectomy (SG) often requires conversion to Roux-en-Y gastric bypass (RYGB) due to gastroesophageal reflux disorder (GERD). Many post-bariatric patients seek body-contouring surgery such as abdominoplasty to remove unwanted skin and fat. While the number of abdominoplasties performed in post-bariatric patients is increasing each year, the number of conversion surgeries is increasing in accordance. This study evaluates the impact of abdominoplasties in patients with prior SG on the development of GERD and the need for conversion to RYGB. Methods A retrospective study was conducted with 630 patients who underwent conversions from SG to RYGB at our institution between January 2014 and September 2023. Outcomes were stratified for comparison between patients with GERD as an indication for conversion and patients with inadequate weight loss as an indication for conversion. Between the two groups we compared the number of patients with post-SG abdominoplasty and the number of hiatal hernias seen during conversion surgery. Results There was a statistically significant higher number of abdominoplasties in patients who underwent conversion to RYGB for GERD (28 patients, 8.4%) compared to inadequate weight loss (13 patients, 4.3%), P-value 0.037. Conversely, there were statistically significantly more hiatal hernias present in patients with inadequate weight loss as an indication for conversion (55 patients, 18.3%) compared to patients with GERD as an indication for conversion (17 patients, 5.1%), P-value < 0.001. Conclusion Our data supports the hypothesis that abdominoplasty surgery alone can increase the development of GERD in post-SG patients, often requiring conversion to RYGB.