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Background: Restrictive bariatric procedures are commonly performed to induce weight reduction, however, some patients may require a second surgery due to inadequate weight loss, weight regain or late complications. Laparoscopic mini gastric bypass (LMGB) is a promising bariatric procedure, which provides an effective long-term weight loss and resolution of primary procedure related complications. Aim of the Work: To assess laparoscopic Mini Gastric Bypass as a bariatric surgical technique for revision after failed primary restrictive bariatric procedure. Cause of revision, weight loss, resolution of primary procedure related co-morbidities and complication rates will be assessed. Patients and Methods: This study included 60 patients with failed primary restrictive bariatric procedures (20 patients with failed sleeve gastrectomy, 20 patients with failed vertical banded gastroplasty and 20 patients with failed adjustable gastric banding) that were converted to laparoscopic MGB with minimal follow-up of 1 year. Results: Among all patient samples (60 patients) , there was significant decrease in mean body mass index after conversion to MGB. The mean BMI before revision was 42.80 ± 3.43 kg/m2 (range, 36-48.9) that decreased to 32.51 ± 3.31 kg/m2 one year after revision. A significant improvement of obesity related co-morbidities was observed after one year, the incidence of remission of diabetes mellitus was 91.6%, while it was 64.7% for hypertension and it was 70.5% for dyslipidemia. Reflux symptoms improved in about 80% ofaffected cases. Complications occurred only in 5% of cases and they were successfully managed. Conclusion: Mini gastric bypass is a safe and effective revisional procedure after failed primary restrictive bariatric surgery that adequate weight loss and satisfactory improvement of the primary procedure related complications.

LAPAROSCOPIC MINI GASTRIC BYPASS AS A REVISIONAL PROCEDURE AFTER FAILED PRIMARY RESTRICTIVE BARIATRIC SURGERY