Revision Surgery

Revision bariatric surgery known as revision surgery refers to a weight loss treatment that follows a previous weight loss surgery that did not lead to the desired level of success. It has different forms as mentioned below.

Why it’s completed

Weight-loss surgery is typically very effective when patients follow their dietary and exercise plans, but in 20-30% of cases, these procedures may simply fail to produce lasting weight loss results and weight regain can occur.

This is not necessarily caused by the patient, sometimes the body simply does not respond well to a particular obesity treatment. When an ineffective procedure results in weight regain, a revision procedure may be the best solution.

Weight Gain or Inadequate Weight Loss after Gastric Bypass Surgery and Revision Surgery

Over time a small percentage of gastric bypass patients will start regaining some of their weight. One reason for the weight gain is that the connection between the stomach pouch and small intestines, which starts out very small, may start to dilate. The patients lose the sense of satiety because the stomach pouch can now empty faster.

Symptoms of failed surgery also include increased stomach capacity as the gastric pouch can stretch and accommodate more food when eating. Another important factor that should be considered is the experience of the surgeon who did the primary gastric bypass surgery.

There might be different points to consider if the first surgeon lacks sufficient expertise. In general, stomach pouch reduction, correcting the bypassed intestines and connection point in between stomach and intestine are the main areas of a revision surgery after Gastric Bypass Surgery.

Revision Surgery for Weight Regain After Gastric Sleeve Surgery (Re-Sleeve)

In some cases, improper eating (frequent large meals, drinking carbonated beverages, and binge eating) or a failure to completely remove all necessary portions of the stomach, can result in weight regain after gastric sleeve surgery. When significant or lasting weight loss is not achieved in patients who have undergone gastric sleeve surgery, a “re-sleeve” may aid in further weight loss. Revision surgery is performed according to our usual technique for laparoscopic Sleeve Gastrectomy.

Conversion to Gastric Bypass Surgery for Weight Regain After Gastric Sleeve Surgery

If gastric sleeve surgery has failed to achieve lasting or desired weight loss in a patient, conversion to a gastric bypass procedure can be an effective alternative for additional weight loss. There are some cases in which gastric sleeve surgery is followed by gastric bypass surgery. This is often referred to as a “staged” approach to bariatric surgery and is typically performed in “high-risk” cases where the second procedure (the gastric bypass surgery) is less risky than it would have been if performed as the first and only procedure.

Risks of Revision Surgery for Weight Regain After Bariatric Surgery

Like any surgical procedure, revision surgery does have risks. Among the most common risks associated with revision surgery are gastro-intestinal leakage, a higher conversion rate to open surgery, infection, longer hospital stays, and possible failure to resolve the original issue.

Other risk factors are as follows:

      • Excessive bleeding
      • Infection
      • Adverse reactions to anesthesia
      • Blood clots
      • Lung or breathing problems
      • Leaks in your gastrointestinal system

Longer term risks and complications can include:

      • Bowel obstruction
      • Dumping syndrome, causing diarrhea, nausea or vomiting
      • Gallstones
      • Hernias
      • Low blood sugar (hypoglycemia)
      • Malnutrition
      • Stomach perforation
      • Ulcers
      • Vomiting

Rarely, complications of Revision surgeries can be fatal.

Food and medications

Before your surgery, you may have restrictions on eating and drinking and which medications you can take.

If you take blood-thinning medications, talk with your doctor before your surgery. Because these medications affect clotting and bleeding, your blood-thinning medication routine may need to be changed.

If you have diabetes, talk with the doctor who manages your insulin or other diabetes medications for specific instructions on taking or adjusting them after surgery.

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