Purpose: This study aimed to assess the outcomes of revisional procedures, namely Roux-en-Y gastric bypass (RYGB) and one anastomosis gastric bypass (OAGB) following unsuccessful laparoscopic sleeve gastrectomy. Materials and Methods: This systematic review and meta-analysis included 817 patients (404 in OAGB group, 413 in RYGB group) from seven retrospective comparative studies. Data on sample size, demographics, perioperative complications, operative time, pre- and post-revisional body mass index, total weight loss, and global weight loss over follow-up were extracted. Results: The mean operative time was 98.2–201 minutes for RYGB versus 78.7–168 minutes for OAGB. Despite classical RYGB gastric bypass taking longer, mini gastric bypass resulted in greater weight loss than RYGB, with a mean difference of −5.84 (95% confidence interval [CI], −6.74 to −4.94; P<0.00001; I 2 =0%), greater total weight loss, and a higher diabetes remission rate (odds ratio [OR], 0.32; 95% CI, 0.14 to 0.71). However, OAGB was associated with a significantly higher incidence of postoperative gastroesophageal reflux than RYGB (52 vs. 31: OR, 0.40; 95% CI, 0.24 to 0.67; P=0.0005; I 2 =0%). Conclusion OAGB was performed more quickly and boasted greater total weight loss and higher diabetes remission rates compared to RYGB after failed sleeve gastrectomy. However, OAGB also demonstrated a higher incidence of postoperative gastroesophageal reflux disease. Thus, careful patient selection is essential when considering OAGB.

Purpose: Our aim in this study is to assess single anastomosis duodeno-ileal bypass (SADI) as a salvage procedure following sleeve gastrectomy (SG), examining its technical feasibility, outcomes, and potential complications. Materials and Methods: A systematic review and meta-analysis were conducted, drawing data from PubMed, Medline, and the Cochrane library. The analysis encompassed 14 studies, involving 1,066 patients. We evaluated operative time, comorbidity resolution (hypertension, dyslipidemia, diabetes), post-operative diarrhea incidence, excess weight loss (EWL) at six, twelve, and twenty-four months, and post-operative leak rates. Results: SADI as a salvage procedure following SG yielded positive outcomes. Mean operative time was 125.98 minutes (95% CI 102.50–149.46, I 2 =99%). Importantly, SADI led to comorbidity resolution in a notable proportion of cases: hypertension in 48% (95% CI 38–57%, I 2 =44%), dyslipidemia in 55% (95% CI 40–69%, I 2 =30%), and diabetes in 63% (95% CI 53–72%, I 2 =30%) of patients. Post-operative diarrhea incidence was relatively low at 2% (95% CI 1–9%, I 2 =75%).In terms of weight loss, SADI patients exhibited substantial EWL: 47.73% (95% CI 37.86–57.61, I 2 =95%) at six months, 59.39% (95% CI 51.18–67.61, I 2 =95%) at twelve months, and 23.84% (95% CI 5.76–41.92, I 2 =100%). At twenty-four months. Furthermore, post-operative leak rate was relatively low, reported in only 1% (95% CI 0–5%, I 2 =80%) of cases. Conclusion SADI as a salvage procedure post-SG demonstrates technical feasibility and marked effectiveness. It offers substantial comorbidity resolution, significant weight loss, and low post-operative complication rates, notably post-operative leaks. Further research should investigate the long-term impact of SADI on patient nutritional status to facilitate its broader adoption.

Purpose: In recent years, the need for revisional bariatric surgery (RBS) procedures has experienced a noteworthy surge to confront complexities and weight recidivism. Despite being a subject of controversy for many, the utilization of the Da Vinci robotic platform (Intuitive Surgical, Inc.) may present benefits in RBS. This study aimed to evaluate the outcomes of robotic RBS in comparison to Laparoscopic RBS.  Methods: A meticulous and thorough analysis was ensured through a comprehensive exploration of the literature, which included PubMed, Medline, Scopus, and Cochrane. This exploration was conducted in adherence to the directives outlined in the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. The NewcastleOttawa scale was used for quality assessment. Results: A total of 11 studies were included in this meta-analysis, comprising 55,889 in the laparoscopic group and 5,809 in the robotic group. No significant differences were observed in the leak, bleeding, operative time, or length of stay across both groups. However, the robotic group showed higher rates of conversion to open surgery (odds ratio [OR], 0.65; 95% confidence interval [CI], 0.53–0.79; p < 0.0001; I 2 = 0%), reoperation (OR, 0.70; 95% CI, 0.57– 0.87; p = 0.0009; I 2 = 6%), and readmission (higher rate of readmission in the robotic group; OR, 0.76; 95% CI, 0.62–0.92; p = 0.005; I 2 = 30%) Conclusion Robotic-assisted bariatric surgery has no significant advantage over conventional laparoscopic surgery. Further research is warranted to explore and evaluatesurgeons’ methodology and proficiency differences.