Bariatric surgery helps people lose weight and improve their health. However, it’s not practical for everyone. Twenty percent of patients, on average, will either gain weight following their first operation or not lose enough weight.
There are several reasons, from complications like severe diarrhea to structural problems such as stomach stretching or nutrient malabsorption. Revision surgery is necessary when these issues arise.
Open
Patients who have undergone bariatric surgery that did not help them lose weight or experience complications or health issues may be candidates for revisional procedures. During your consultation, you and your surgeon will weigh your options together, along with your long-term goals and current health.
Revision surgery can be done laparoscopically, and many bariatric doctors perform dozens of these surgeries each year. The procedure involves sedation, a flexible scope, and tiny incisions that minimize risk and recovery time.
The human body has a remarkable ability to adapt, even after a surgical procedure like bariatric surgery. Over time, the stomach pouch that has been created after your original surgery can stretch, causing problems such as weight regain, dumping syndrome, or gastrointestinal issues like acid reflux.
Laparoscopic
Bariatric surgery revision is done laparoscopically, meaning the surgeon inserts a small camera and instruments through several small incisions. This method reduces postoperative pain and shortens recovery times. However, a few cases require a larger incision to access the abdominal cavity.
About one in 20 patients who had a bariatric procedure at some point in their lives need another operation because of complications or too little weight loss. Most of these surgeries are also laparoscopic, but some are open procedures.
Patients who have had a laparoscopic adjustable gastric banding surgery may need a revision because the band has slipped, eroded, or been removed. This is common in people who have had this type of surgery for over ten years.
Laparoscopic techniques have also made it possible to perform two-stage operations, which are particularly useful for super-obese patients. This allows patients to start with a sleeve gastrectomy and then undergo the second stage of a duodenal switch after 40-50 kilograms of weight loss. This approach is more effective than the two-stage procedure with traditional open methods because the surgeon would have to fight through dense adhesions that could make a second surgery extremely difficult.
It is essential for people who have undergone bariatric surgery to remember that their life will change drastically. They must be dedicated to their new dietary regimen and willing to stick with it for the rest of their lives. Otherwise, they will likely experience a return to their pre-surgery condition or even worsen the results of their original operation.
Gastric Bypass
Surgical procedures that modify the stomach and intestines promise significant results for people who are severely obese or who have obesity-related health problems. These procedures restrict the amount of food eaten, reduce nutrient absorption, and improve the body’s ability to lose weight.
Bariatric surgery gives the best potential for long-term, considerable weight loss and improvement of health issues. However, patients must make significant changes in lifestyle to ensure success. That means eating smaller meals, choosing healthy foods, exercising regularly, addressing psychological issues, and taking vitamins and minerals.
If a patient is unable to lose more weight or has experienced complications from gastric bypass, a revision operation may help. This procedure is more complicated than the original, so patients must undergo a careful evaluation and be prepared for a more extended recovery period.
During this procedure, doctors staple the top portion of the stomach to create a small pouch that limits food intake. They also attach a section of the small intestine to the bag, bypassing part of the lower stomach and reducing the absorption of calories and nutrients. This type of bypass has been around for decades, but it lost favor to laparoscopic sleeve gastrectomy in recent years. However, It is still used as a first option for better candidates for other weight loss operations.
Sleeve Gastrectomy
One of the most popular bariatric procedures in the US is the sleeve gastrectomy, which involves removing a significant stomach section. It offers good long-term weight loss, less hunger, a change in food cravings and satisfaction with eating, improved blood sugar control in diabetic patients, and more.
During a sleeve gastrectomy, your surgeon uses laparoscopic techniques and small incisions instead of making a large cut into your abdominal cavity. The sleeve surgery typically takes between 20 and 30 minutes.
If your stomach pouch becomes enlarged or stretched out over time, you may need a revision bariatric surgery to restore the effectiveness of your procedure. The surgery can be done through the same minimally invasive method as your original procedure.
The sleeve reduces your body’s production of the hormone ghrelin, which makes you hungry. It also restricts your calorie intake and encourages healthy eating habits. This surgery has the added benefit of being reversible.
If you have had a sleeve gastrectomy and then experienced problems such as inadequate weight loss or a loss of appetite, your doctor might recommend that you undergo a conversion to another type of bariatric surgery.