Vertical Banded Gastroplasty Revisions: A Single-Center Experience

Background Revising bariatric procedures presents significant challenges, particularly in patients with previous vertical banded gastroplasty (VBG). Among the various revision techniques, Roux-en-Y gastric bypass (RYGB) and VBG reversal are the most commonly performed. Methodology This retrospective study analyzed all patients who underwent revision after VBG at our center between 2010 and 2021. Data were reviewed regarding indications, preoperative planning, surgical techniques, and early outcomes. Results Of the 234 revisional bariatric procedures performed between 2010 and 2021, 55 (23.5%) were VBG revisions. Among these, 33 patients underwent conversion to RYGB, 16 had gastrogastrostomy-assisted VBG reversal, three underwent mini-gastric bypass, and one each underwent conversion to laparoscopic sleeve gastrectomy, biliopancreatic diversion, and anterior plication. All but three procedures were completed laparoscopically. No mortalities occurred. Postoperative complications included two anastomotic leaks and two cases of intraluminal bleeding. The most common indication for reversal was excessive weight loss, whereas inadequate weight loss was the leading indication for conversion. Conclusions VBG revision is a technically demanding procedure that requires advanced surgical expertise. Laparoscopic revision is a safe, practical, and effective solution for VBG failure or complications.