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Background and Objectives <p>Bariatric surgery, in particular Roux-en-Y gastric bypass (RYGB), has been a well proven and effective means of long-term management of severe obesity. However, about 10–35% of patients have a suboptimal clinical response (lowest quartile of weight loss after RYGB surgery) or suffer from recurrent weight gain often resulting in additional surgery.&#xa0;This study investigates the short-term results on weight loss and complications of surgical revision of the pouch in combination with placement of a MiniMizer ring in patients with a suboptimal clinical response or recurrent weight gain after RYGB.</p> Methods <p>All patients who underwent pouch revision in combination with placement of a MiniMizer ring in the Zuyderland Medical Center between January 2016 and December 2021 were included. Weight, obesity-related complication resolution, and complications were monitored and reported during the follow-up appointments at the Nederlandse Obesitas Kliniek up to 2&#xa0;years post-revisional surgery.</p> Results <p>Thirty-six patients were included. These patients had a mean %TWL of 12.3 and 13.5 at 12 and 24&#xa0;months post-revisional surgery. This resulted in a cumulative %TWL of 28.7 at 24&#xa0;months after the revisional procedure. Patients with a superior response after the primary RYGB procedure (%TWL ≥ 35) responded better in %TWL post-revisional surgery compared to patients with a suboptimal response after the primary RYGB with a cumulative %TWL of 33.9 and 17.5 respectively. One ring-related complication occurred.</p> Conclusions <p>Pouch revision in combination with placement of a MiniMizer ring appears to be a promising approach for managing patients with a suboptimal clinical response or recurrent weight gain after RYGB. The procedure offers significant additional weight loss with a low complication rate.</p>

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Pouch Revision in Combination with Placement of a MiniMizer Ring as a Revisional Procedure in Patient with Suboptimal Clinical Response or Recurrent Weight Gain After RYGB

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年7月5日

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  • Sophie C. van Helmond,
  • Marijn T.F. Jense,
  • Geert H.J.M. Verkoulen,
  • Evelien De Witte,
  • Pieter P.H.L. Broos,
  • Jan Willem M. Greve,
  • Evert-Jan G. Boerma

摘要

Background and Objectives

Bariatric surgery, in particular Roux-en-Y gastric bypass (RYGB), has been a well proven and effective means of long-term management of severe obesity. However, about 10–35% of patients have a suboptimal clinical response (lowest quartile of weight loss after RYGB surgery) or suffer from recurrent weight gain often resulting in additional surgery. This study investigates the short-term results on weight loss and complications of surgical revision of the pouch in combination with placement of a MiniMizer ring in patients with a suboptimal clinical response or recurrent weight gain after RYGB.

Methods

All patients who underwent pouch revision in combination with placement of a MiniMizer ring in the Zuyderland Medical Center between January 2016 and December 2021 were included. Weight, obesity-related complication resolution, and complications were monitored and reported during the follow-up appointments at the Nederlandse Obesitas Kliniek up to 2 years post-revisional surgery.

Results

Thirty-six patients were included. These patients had a mean %TWL of 12.3 and 13.5 at 12 and 24 months post-revisional surgery. This resulted in a cumulative %TWL of 28.7 at 24 months after the revisional procedure. Patients with a superior response after the primary RYGB procedure (%TWL ≥ 35) responded better in %TWL post-revisional surgery compared to patients with a suboptimal response after the primary RYGB with a cumulative %TWL of 33.9 and 17.5 respectively. One ring-related complication occurred.

Conclusions

Pouch revision in combination with placement of a MiniMizer ring appears to be a promising approach for managing patients with a suboptimal clinical response or recurrent weight gain after RYGB. The procedure offers significant additional weight loss with a low complication rate.