Online Articles: Technical ReportsNovel Technique of Distal Roux-en-Y Gastric Bypass for Insufficient Weight Loss After Primary Procedure: Personal Experience and Primary Results at 12 MonthsThomopoulos, Theodoros MD*,†; Tomasi, Vincent MD*; Koliakos, Evangelos MD*; Thoma, Maximilien MD*; Navez, Benoit MD*Author Information *Oesogastroduodenal and Bariatric Unit, Department of Abdominal Surgery and Transplantation, Saint-Luc University Hospital, Brussels, Belgium †Obesity Surgical Center, Saint Michel Clinic, Toulon, France Informed consent was obtained from all individual participants included in the study. All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. The authors declare no conflicts of interest. Reprints: Theodoros Thomopoulos, MD, Oesogastroduodenal and Bariatric Unit, Department of Abdominal Surgery and Transplantation, Saint-Luc University Hospital, 10 Avenue Hippocrate, Brussels 1200, Belgium (e-mail: firstname.lastname@example.org). Surgical Laparoscopy, Endoscopy & Percutaneous Techniques: August 2018 - Volume 28 - Issue 4 - p e83-e87 doi: 10.1097/SLE.0000000000000537 Buy Metrics Abstract Purpose: In the literature, up to 20% of patients present a failure of weight loss after primary Roux-en-Y gastric bypass (RYGBP) or other restrictive procedures. Our aim is to describe the midterm results of our novel technique of distal Roux-en-Y gastric bypass (DRYGBP) as a revisional procedure. Materials and Methods: We performed our DRYGBP in 21 patients. The length of the common channel was 100 cm, whereas the lengths of the alimentary and the biliopancreatic limbs were 2/3 and 1/3 of the remaining bowel, respectively. We created 2 subgroups, a “revisional” group after failed restrictive procedures and a “distalization” group after failed RYGBP. Results: The mean excess weight loss at 12 months in the “revisional” group (10 patients) was 67.8% and in the “distalization” group (11 patients) 57.1%. We did not experience any mortality nor severe morbidity rates. Conclusions: In our experience, our DRYGBP differentiated procedure seems to be effective at 12 months. Copyright © 2018 Wolters Kluwer Health, Inc. All rights reserved.