Skip to main content
SpringerLink
Log in

Redo-Eingriffe und Komplikationsmanagement in der bariatrischen Chirurgie

Redo intervention and complication management in bariatric surgery

  • CME Zertifizierte Fortbildung
  • Published:
Der Chirurg Aims and scope Submit manuscript

Zusammenfassung

Die morbide Adipositas und die damit assoziierten Begleiterkrankungen haben pandemische Ausmaße angenommen. Die bariatrische Chirurgie hat sich in diesem Kontext als effektive Therapie etabliert. 2011 wurden weltweit über 340.000 adipositaschirurgische Eingriffe durchgeführt. Damit einher geht ein steigender Bedarf an sog. Redo-Operationen, sei es wegen revisionsbedürftiger Komplikationen oder wenn das Therapieziel einer nachhaltigen Gewichtsreduktion nicht erreicht werden konnte.

Redo-Operationen und das Komplikationsmanagement bedürfen einer sorgfältigen Anamnese und Diagnostik sowie einer exakten Kenntnis über die durch den Primäreingriff veränderte Anatomie, um die für den Patienten korrekte Folgeoperation durchführen zu können.

Abstract

Morbid obesity and the associated comorbidities are rapidly increasing worldwide. Bariatric surgery has proven to be an effective treatment option. In 2011 more then 340,000 bariatric procedures were performed worldwide which is accompanied by a growing demand for revision bariatric procedures due to complications or failure, such as insufficient weight loss or weight regain.

Redo operation procedures as well as the management of complications require a profound preoperative medical history and diagnostic investigation in combination with an exact knowledge of the anatomical changes made in the primary procedure.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Abb. 1
Abb. 2
Abb. 3
Abb. 4
Abb. 5
Abb. 6

Literatur

  1. Finucane MM, Stevens GA, Cowan MJ et al (2011) National, regional, and global trends in body-mass index since 1980: systematic analysis of health examination surveys and epidemiological studies with 960 country-years and 9.1 million participants. Lancet 377:557–567

    Article  PubMed  Google Scholar 

  2. Buchwald H, Oien DM (2013) Metabolic/bariatric surgery worldwide 2011. Obes Surg 23:427–436

    Article  PubMed  Google Scholar 

  3. Stroh C, Weiner R, Horbach T et al (2013) New data on quality assurance in bariatric surgery in Germany. Zentrabl Chir 138:180–188

    CAS  Google Scholar 

  4. Patel S, Szomstein S, Rosenthal RJ (2011) Reasons and outcomes of reoperative bariatric surgery for failed and complicated procedures (excluding adjustable gastric banding). Obes Surg 21:1209–1219

    Article  PubMed  Google Scholar 

  5. Saber AA, Elgamal MH, Mcleod MK (2008) Bariatric surgery: the past, present, and future. Obes Surg 18:121–128

    Article  PubMed  Google Scholar 

  6. Gill RS, Karmali S, Sharma AM (2011) The potential role of the Edmonton obesity staging system in determining indications for bariatric surgery. Obes Surg 21:1947–1949

    Article  PubMed  Google Scholar 

  7. Karcz WK (2012) Principles of metabolic surgery. Springer, Berlin

  8. Awad S, Carter S, Purkayastha S et al (2014) Enhanced Recovery After Bariatric Surgery (ERABS): clinical outcomes from a tertiary referral bariatric centre. Obes Surg 24:753–758

    Article  PubMed Central  PubMed  Google Scholar 

  9. Hasenberg T, Shang E (2011) Operative Verfahren zur Behandlung der morbiden Adipositas. Adipositas 1:37–45

    Google Scholar 

  10. Griffith PS, Birch DW, Sharma AM et al (2012) Managing complications associated with laparoscopic Roux-en-Y gastric bypass for morbid obesity. Can J Surg 55:329–336

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  11. Bellorin O, Abdemur A, Sucandy I et al (2011) Understanding the significance, reasons and patterns of abnormal vital signs after gastric bypass for morbid obesity. Obes Surg 21:707–713

    Article  PubMed  Google Scholar 

  12. Benotti P, Wood GC, Winegar DA et al (2014) Risk factors associated with mortality after Roux-en-Y gastric bypass surgery. Ann Surg 259:123–130

    Article  PubMed  Google Scholar 

  13. Aurora AR, Khaitan L, Saber AA (2012) Sleeve gastrectomy and the risk of leak: a systematic analysis of 4,888 patients. Surg Endosc 26:1509–1515

    Article  PubMed  Google Scholar 

  14. Shi X, Karmali S, Sharma AM et al (2010) A review of laparoscopic sleeve gastrectomy for morbid obesity. Obes Surg 20:1171–1177

    Article  PubMed  Google Scholar 

  15. Shnell M, Fishman S, Eldar S et al (2014) Balloon dilatation for symptomatic gastric sleeve stricture. Gastrointest Endosc 79:521–524

    Article  PubMed  Google Scholar 

  16. Carelli AM, Youn HA, Kurian MS et al (2010) Safety of the laparoscopic adjustable gastric band: 7-year data from a U.S. center of excellence. Surg Endosc 24:1819–1823

    Article  PubMed  Google Scholar 

  17. Owers C, Ackroyd R (2013) A study examining the complications associated with gastric banding. Obes Surg 23:56–59

    Article  PubMed  Google Scholar 

  18. Egan RJ, Monkhouse SJ, Meredith HE et al (2011) The reporting of gastric band slip and related complications; a review of the literature. Obes Surg 21:1280–1288

    Article  PubMed  Google Scholar 

  19. Hsieh T, Zurita L, Grover H et al (2014) 10-year outcomes of the vertical transected gastric bypass for obesity: a systematic review. Obes Surg 24:456–461

    Article  PubMed  Google Scholar 

  20. Christou N, Efthimiou E (2009) Five-year outcomes of laparoscopic adjustable gastric banding and laparoscopic Roux-en-Y gastric bypass in a comprehensive bariatric surgery program in Canada. Can J Surg 52:E249–E258

    PubMed Central  PubMed  Google Scholar 

  21. Iannelli A, Schneck AS, Hebuterne X et al (2013) Gastric pouch resizing for Roux-en-Y gastric bypass failure in patients with a dilated pouch. Surg Obes Relat Dis 9:260–267

    Article  PubMed  Google Scholar 

  22. Vijgen GH, Schouten R, Bouvy ND et al (2012) Salvage banding for failed Roux-en-Y gastric bypass. Surg Obes Relat Dis 8:803–808

    Article  PubMed  Google Scholar 

  23. Parikh M, Heacock L, Gagner M (2011) Laparoscopic „gastrojejunal sleeve reduction“ as a revision procedure for weight loss failure after roux-en-y gastric bypass. Obes Surg 21:650–654

    Article  PubMed  Google Scholar 

  24. Rawlins ML, Teel D II, Hedgcorth K et al (2011) Revision of Roux-en-Y gastric bypass to distal bypass for failed weight loss. Surg Obes Relat Dis 7:45–49

    Article  PubMed  Google Scholar 

  25. Stefater MA, Wilson-Perez HE, Chambers AP et al (2012) All bariatric surgeries are not created equal: insights from mechanistic comparisons. Endocr Rev 33:595–622

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  26. Karmali S, Brar B, Shi X et al (2013) Weight recidivism post-bariatric surgery: a systematic review. Obes Surg 23:1922–1933

    Article  PubMed  Google Scholar 

  27. Dapri G, Cadiere GB, Himpens J (2011) Laparoscopic conversion of Roux-en-Y gastric bypass to distal gastric bypass for weight regain. J Laparoendosc Adv Surg Tech A 21:19–23

    Article  PubMed  Google Scholar 

  28. Rosenthal RJ, International Sleeve Gastrectomy Expert P, Diaz AA et al (2012) International Sleeve Gastrectomy Expert Panel Consensus Statement: best practice guidelines based on experience of > 12,000 cases. Surg Obes Relat Dis 8:8–19

    Article  PubMed  Google Scholar 

  29. Peterli R, Borbely Y, Kern B et al (2013) Early results of the Swiss Multicentre Bypass or Sleeve Study (SM-BOSS): a prospective randomized trial comparing laparoscopic sleeve gastrectomy and Roux-en-Y gastric bypass. Ann Surg 258:690–695

    Article  PubMed Central  PubMed  Google Scholar 

  30. Schauer PR, Bhatt DL, Kirwan JP et al (2014) Bariatric surgery versus intensive medical therapy for diabetes – 3-year outcomes. N Engl J Med 370:2002–2013

    Article  PubMed  Google Scholar 

  31. Sieber P, Gass M, Kern B et al (2013) Five-year results of laparoscopic sleeve gastrectomy. Surg Obes Relat Dis [Epub ahead of print]

  32. Corona M, Zini C, Allegritti M et al (2013) Minimally invasive treatment of gastric leak after sleeve gastrectomy. Radiol Med 118:962–970

    Article  PubMed  Google Scholar 

  33. Himpens J, Dobbeleir J, Peeters G (2010) Long-term results of laparoscopic sleeve gastrectomy for obesity. Ann Surg 252:319–324

    Article  PubMed  Google Scholar 

  34. Weiner RA, Theodoridou S, Weiner S (2011) Failure of laparoscopic sleeve gastrectomy – further procedure? Obes Facts 4(Suppl 1):42–46

    PubMed  Google Scholar 

  35. Noel P, Nedelcu M, Nocca D et al (2013) Revised sleeve gastrectomy: another option for weight loss failure after sleeve gastrectomy. Surg Endosc [Epub ahead of print]

  36. Gero D, Dayer-Jankechova A, Worreth M et al (2014) Laparoscopic gastric banding outcomes do not depend on device or technique. Long-term results of a Prospective Randomized Study comparing the Lapband(R) and the SAGB(R). Obes Surg 24:114–122

    Article  PubMed  Google Scholar 

  37. Brown WA, Egberts KJ, Franke-Richard D et al (2013) Erosions after laparoscopic adjustable gastric banding: diagnosis and management. Ann Surg 257:1047–1052

    Article  PubMed  Google Scholar 

  38. Lee WK, Kim SM (2014) Three-year experience of pouch dilatation and slippage management after laparoscopic adjustable gastric banding. Yonsei Med J 55:149–156

    Article  PubMed Central  PubMed  Google Scholar 

  39. Te Riele WW, Van Santvoort HC, Boerma D et al (2014) Rebanding for slippage after gastric banding: should we do it? Obes Surg 24:588–593

    Article  Google Scholar 

  40. Stroh C, Benedix D, Weiner R et al (2014) Is a one-step sleeve gastrectomy indicated as a revision procedure after gastric banding? Data analysis from a quality assurance study of the surgical treatment of obesity in Germany. Obes Surg 24:9–14

    Article  PubMed  Google Scholar 

  41. Marin-Perez P, Betancourt A, Lamota M et al (2014) Outcomes after laparoscopic conversion of failed adjustable gastric banding to sleeve gastrectomy or Roux-en-Y gastric bypass. Br J Surg 101:254–260

    Article  CAS  PubMed  Google Scholar 

  42. Aarts EO, Dogan K, Koehestanie P et al (2013) What happens after gastric band removal without additional bariatric surgery? Surg Obes Relat Dis [Epub ahead of print]

Download references

Einhaltung ethischer Richtlinien

Interessenkonflikt. T. Hasenberg und M. Niedergethmann geben an, dass kein Interessenkonflikt besteht. Dieser Beitrag beinhaltet keine Studien an Menschen oder Tieren.

Author information

Authors and Affiliations

  1. Klinik für Allgemein- und Viszeralchirurgie, Alfried Krupp Krankenhaus, Hellweg 100, 45276, Essen, Deutschland

    T. Hasenberg & M. Niedergethmann

Authors
  1. T. Hasenberg
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. M. Niedergethmann
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to T. Hasenberg.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Hasenberg, T., Niedergethmann, M. Redo-Eingriffe und Komplikationsmanagement in der bariatrischen Chirurgie. Chirurg 85, 643–654 (2014). https://doi.org/10.1007/s00104-013-2682-x

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00104-013-2682-x

Schlüsselwörter

Keywords

Search

Navigation