Adding malabsorption for weight loss failure after gastric bypass

To present a technique of revisional RY gastric bypass in patients with unsatisfactory weight loss after primary gastric bariatric operations. The Roux limb was lengthened by creating a 75-100 cm common channel below the enteroenterostomy with concomitant revision of the gastrojejunostomy. Fifty-four patients had this distal modification of RYGB including 47 patients who had primary gastric bypass and 7 patients who failed pure restrictive operations. Mean excess weight loss was 47.9% in patients followed for > or = 1 year. This distal modification of RYGB resulted in satisfactory weight loss for nearly half of the 54 patients in this series.