Surgical Options for Weight Regain after Sleeve Gastrectomy

Chan W. Park, MD, FACS

Co-Director Duke Bariatric & MIS Fellowship

Assistant Professor of Surgery

Debate: RYGB may NOT be the best option…

Disclosures

• Covidien/Medtronic – Consultant

• Gore – Consultant, Educational Grant

• Teleflex – Consultant

• TransEnterix – Consultant

Sleeve Gastrectomy

• 1st part of the BPD-DS

Weight Regain

• Significant for all bariatric procedures

• Mechanism for weight regain after Sleeve:

– Sleeve dilation

– Poor patient compliance/diet

• No “dumping”

• Less dietary restrictions

Sleeve Volume

Re-sleeve

ReSG

LSG to LRYGB

Algorithm for Management of Weight Regain after Sleeve

Summary

• Sleeve Gastrectomy is one of the most commonly performed bariatric procedures in US

• There is some weight regain with all bariatric procedures

• For weight regain after sleeve, surgical options include re-sleeve, gastric bypass, and duodenal switch