Correction of body weight regain after Roux-en-Y gastric bypass. Clinical case

Abstract

Obesity and overweight are health problems that indicate excessive and abnormal accumulation of body fat and lead to adverse health effects. Epidemiological studies have identified obesity and overweight as risk factors for several diseases, including diabetes, various cancers, cardiovascular disease, and hypertension. Roux‑en‑Y gastric bypass is one of the most common operations performed for the patients with morbid obesity. With the long‑term follow‑up of bariatric surgery, insufficient weight loss or weight regain is becoming more frequently encountered after RYGB. Insufficient weight loss or weight regain after proximal Roux‑en‑Y gastric bypass occurs in 35% of cases. As a result, revisional surgery will be more frequently performed. No consensus has been reached on the best revisional operation for these patients. The presented clinical case demonstrates tactical approaches to a comprehensive examination of patients who are scheduled for revision surgery due to insufficient weight loss or weight regain after Roux‑en‑Y gastric bypass. 3D computer gastrovolumetry is an effective method that allows the qualitative and quantitative examination of the state of the proximal gastric pouch after Roux‑en‑Y gastric bypass. The presented clinical case demonstrates the importance of an individualized approach for each patient, according to the recommendations of the multidisciplinary team for diagnosis and correct surgical strategy treatment weight regain after Roux‑en‑Y gastric bypass. Combined reconstruction of the gastric pouch with gastroenteroanastomosis and distalization of the alimentary loop is a safe and effective method of correction of weight regain in patients after Roux‑en‑Y gastric bypass.