Reoperation for Failed Gastric Bypass Procedures for Obesity

Reoperation is worthwhile when there is an obvious defect in the gastric reduction operation that has failed to control weight. Reoperation occasionally is necessary to correct a complication of gastric bypass. Vertical banded gastroplasty is the procedure of choice for reoperations, as it provides weight control while limiting the problems of a bypass. It is the only reoperation used and the only primary operation for morbid obesity at the authors' institution. Conversion of a horizontal to a vertical pouch is safe but requires careful attention to the technique to avoid injury to nearby organs and to preserve the blood supply to the stomach.