Revisional Bariatric Surgery
Weight loss surgery is typically very successful and represents the most effective long-term weight loss solution for those suffering from obesity. However, as with any type of surgery circumstances may arise that require revising the primary procedure. Fortunately, these circumstances rarely occur. Revision bariatric surgery consists of another procedure that improves on or corrects the primary operation. Most procedures performed today can, in some way, be revised in case of poor weight loss or a failure due to causes beyond the patient’s control.
When a patient comes to our office and has not experienced the degree of weight loss they expected, or they have regained a significant amount weight, the first goal is to find out the root cause of the problem. If the issue revolves around poor dietary or exercise habits after the primary surgical procedure, we look to implement a lifestyle modification program to get the patient back on track. Further, the weight gain may be perfectly normal as patients tend to regain some weight over the course of time as their stomachs adapt to eating more food.
Revisional surgery is reserved for those patients who cannot get back on track via diet or exercise alone or for those whose primary bariatric surgery definitively failed. We offer revisional bariatric surgery as a last resort because it does carry higher risk than a primary bariatric procedure. Following, we will discuss the most common revisions of a primary procedure:
Gastric Bypass Revision
The gastric bypass can be reversed, as no part of the gastrointestinal system is removed from the body. While the gastric bypass is meant to be a permanent procedure, it is relatively easily revised. If the weight regain is due to dilation of the stoma, various endoscopic procedures including Transoral Outlet Reduction or TORe are available to correct it.
Gastric Sleeve Revision
The gastric sleeve has proven to be a very popular and effective procedure, however, as with any procedure, it may not offer the degree of weight loss the patient expects. The gastric sleeve can be revised to a gastric bypass by modifying the stomach pouch as well as bypassing part of the small intestine.
Gastric Band Revisions
Because the gastric band is reversible, it can be removed, allowing for the most flexibility in revision. Therefore, any bariatric surgical procedure can be performed once the band has been removed from the stomach and the patient has had time to heal.
Weight loss surgery patients that undergo a revision will have the benefit of understanding the pre-and post-operative process intimately. As a result, revisional surgery tends to be very successful in qualified patients. However, we reserve a revision surgery to those who absolutely need it and cannot correct their weight regain or lack of weight loss through more conservative measures or lifestyle change.