Revisional bariatric surgery (RBS) is the third most common bariatric surgery performed in the United States. RBS is likely to increase with time and may soon surpass Roux-en-Y gastric bypass (RYGB) in volume. The Metabolic and Bariatric Surgery Quality Improvement and Accreditation Program (MBSAQIP) tracks bariatric cases. Our goal was to evaluate the MBSAQIP for revisional bariatric surgery trends.


The 2020 MBSAQIP Participant Use File (PUF) was used to look at the number and type of RBS and compared to similar MBSAQIP data over the previous five years. All cases listed under the Revision tag were included in the analysis. Procedures considered included RYGB, sleeve gastrectomy (SG), adjustable gastric band (AGB), biliopancreatic diversion (BPD) and single anastomosis duodenoileal bypass (SADI). Descriptive statistics were used.


There were 197,812 cases reported in the PUF. Of these, 26,652 (13.5%) were revisions, conversions or reoperations. Stapled non emergent procedures dominated with 19,763. There were 4,291 SG conversions and 682 re-sleeves. There were 9,217 RYGB conversions and 3,221 revisions. There were 2,067 AGB revisions, 883 BPD revisions or conversions, and 424 SADI revisions or conversions.


A 40.2% percent increase of RBS was seen from 2015 to 2019 but COVID was responsible for a 22.8% decrease in 2020. It is anticipated that RBS will resume its upward trend after the pandemic passes. AGB revisions have decreased, while SADI revisions have increased. The largest percentage of growth has been in SG conversions.