310 Outcomes and Safety Profile of Revisional Bariatric Surgery: Insights from Over a Decade of Experience

Abstract Aim To evaluate long-term outcomes, indications, complications, and weight loss following revisional bariatric surgery in a single UK bariatric centre over an 11-year period. Method A retrospective review was conducted of all patients who underwent revisional bariatric surgery between February 2014 and February 2025, excluding isolated gastric band removals and abandoned procedures. Collected data included demographics, type of primary and revisional procedures, indications for revision, BMI and excess weight loss (EWL) trajectories, complications (graded by Clavien-Dindo), and length of stay. Results A total of 85 revisional procedures were analysed. The most frequent primary operation requiring revision was gastric banding (63.3%), followed by sleeve gastrectomy (30%). The most common revisional operation performed was Roux-en-Y gastric bypass (81.1%). Indications included weight regain, food intolerance, and complications such as GORD. Mean time from primary to revisional surgery was 6.6 years. EWL improved by 49.9% from primary to revisional surgery. Clavien-Dindo grade ≥III complications occurred in 5.9% of patients. No mortalities were recorded, and median length of stay was 2 days. Symptom resolution was reported in all cases at follow-up. Conclusions Revisional bariatric surgery is safe and effective in addressing complications and suboptimal outcomes following primary bariatric procedures. Roux-en-Y gastric bypass remains the most common and successful revisional approach. These findings support the importance of multidisciplinary assessment and tailored procedural selection to optimise outcomes. Further prospective data are needed to assess long-term sustainability.