ORIGINAL CONTRIBUTIONS Laparoscopic Roux-en-Y Gastric Bypass After Failed Vertical Banded Gastroplasty: 2-Year Follow-up of 102 Patients Mohamed D. Sarhan 1,2 & M. AbdelSalam N. 2 & Mohamed Saber Mostafa 1,2 & AbdelRahman Yehia 1 & Ismail Anwar 3 & Ehab Fathy 1,2 Received: 8 December 2020 /Revised: 24 February 2021 /Accepted: 25 February 2021 # The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature 2021 Abstract Background Vertical banded gastroplasty (VBG) is now discarded from being a restrictive procedure for morbid obesity due to its many drawbacks, doubtful efficacy, and lots of post-operative complications. Roux-en-Y gastric bypass (RYGB) is the most commonly performed procedure for VBG revision. So we aimed at reporting our experience in conversional RYGB for a failed VBG. Material and Methods Analyzing follow-up records of 102 patients who underwent revisional RYGB after failed VBG in the period from April 2014 to January 2018. Results A total of 102 laparoscopic revisions of failed VBGs to RYGB were performed. The mean operating time was 161.9 min ±29.2 and the mean length of the hospital stay was 1.5 days ±1.2. Fourteen patients (13%) developed early post-operative complications (gastrojejunostomy leak 5; bleeding 9). Four patients (4.7%) developed late complications (Port site hernia 2; internal hernia 1; Stomal ulcer 1). The mean BMI pre-RYGB was 46.6 ± 5.9 kg/m 2 , and the mean %EBWL (percent excess body weight lost) of the patients at 12 and 24 months post-revision were 56.2% and 64.3%, respectively. Our patients had immediate post- revision resolution of VBG-related complications like dysphagia and vomiting. We also report improvement in all obesity-related health problems with (75.7%) complete remission rate and (24.3%) partial remission or improvement rate of diabetes mellitus. Conclusion Conversion of VBG to RYGB is a feasible procedure and is associated with acceptable early morbidity rates and reduced lengths of hospitalization also it provides acceptable weight loss and improvement in obesity-related health problems. Keywords Roux-en-Y gastric bypass . Vertical banded gastroplasty . Laparoscopy . Re-operation . Bariatric surgery Introduction Vertical band gastroplasty (VBG) was introduced in the late 1970s as an alternative to gastric bypass [1]. This operation took the lead of bariatric surgeries until the early beginning of the current century [2]. Thousands of patients were operated upon with satisfactory initial outcomes. Despite that, VBG caused a high proportion of complications, both anatomic (staple line disruption, stricture of the stoma, pouch dilatation) and functional (severe food intolerance and GERD) [3]. In addition to weight loss failure and weight recidivism, this eventually led to the stoppage of this procedure in many parts of the world [4]. The conversion to Roux-en-Y gastric bypass (RYGB) has been described by different authors as the best option for op- timum weight control and resolution of VBG complications, and it is associated with low rates of early or late complica- tions [5]. Numerous difficulties are related to the altered anatomy and adhesions, and identifying previous staple lines is not always easy, especially after undivided VBG. The pres- ence of fibrotic tissues makes staple lines fragile and more * M. AbdelSalam N. m8abdelsalam8m@yahoo.com 1 Department of General and Laparoscopic Surgery - Faculty of Medicine, Cairo University, Giza, Egypt 2 Arab Bariatric and Plastic Center, 15 Amr Street - Al Mohandesin, Giza, Egypt 3 Department of Endemic Hepatology and Gastroenterology - Faculty of Medicine, Cairo University, Giza, Egypt https://doi.org/10.1007/s11695-021-05328-7 / Published online: 4 March 2021 Obesity Surgery (2021) 31:2717–2722