Revision surgery can also be referred to as revisional or conversion surgery. This is known as weight loss surgery that follows an initial surgery that did not produce the desired results. At Alleghenies Surgical we refer to it as second chance surgery, because it an opportunity to obtain the desired results by performing a revising of the previous surgery or converting one weight loss surgery to a different one. Everyone goes into weight loss surgery with the intent of success, however some patients do not reach their goals. There are many reasons why this can occur; more importantly we are here to offer treatment options to help you reach your goals.
Revisions After LAP BAND Surgery
The LAP BAND system may need to be revised due to either device-related problems or unsatisfactory weight loss. These are not common however they do happen in some patients. A complication specific to this type of procedure is slippage of the gastric band, which requires a follow-up procedure to fix the problem by repositioning the band. While some patients will have the band replaced, others choose to revise to another weight loss procedure.
Revisions After Sleeve Gastrectomy Surgery
A revision of a sleeve gastrectomy may be necessary due to complications, unsatisfactory weight loss, or weight regain. Complications that may occur after sleeve gastrectomy surgery are chronic reflux, chronic vomiting, stricture (narrowing) or a staple line complication can often be improved through revisional bariatric surgery.
Revisions After Gastric Bypass Surgery
A gastric bypass revision is necessary in some patients due to complications, unsatisfactory weight loss, or weight regain. Complications that may occur after gastric bypass surgery, such as ulcers, chronic vomiting, hernia, staple line failure, can often be improved through revisional bariatric surgery. If surgical complication, such as popped staple line, ulcers, or hernia, the bariatric surgeon will need to surgically repair the problem
Evaluation and treatment options
If the problem is lack of weight loss or weight regain, non-surgical approach includes examining eating habits and exercise routines and participating in nutritional counseling, exercise program, behavior modification therapy, psychological counseling, and support groups.
Next an evaluation of the surgical tool will be conducted to evaluate if there is any mechanical reason for poor weight loss or weight regain.
In appropriate candidates, the use of a pharmacological treatment plan (weight loss medication) may be indicated to help initiate additional weight loss.
Occasionally, a patient may need their weight loss surgery converted (changed) to a different weight loss surgery in order to help them reach their goals or get back to the initial postoperative weight loss they had previously achieved.
- The LAP-BAND can be removed and at the same time the patient can have a gastric bypass procedure
- The sleeve gastrectomy can be changed to a gastric bypass procedure.
- The gastric bypass can be converted to distal gastric bypass or conversion to duodenal switch.
- If stomach pouch or stomach opening of the gastric bypass has enlarged, a LAP BAND may be added to reduce amount of food that can be eaten and slow the movement of food from the
stomach to the small intestine.
- If stomach pouch (of sleeve or gastric bypass) or stomach opening has enlarged, the bariatric surgeon can try and fix the problem by re-operating to either remove more stomach
and re-stapling the stomach line or stitching up the stomach opening to make it smaller, although it may only be a temporary fix and happen again.
- StomaphyX, a non-surgical revision for gastric bypass surgery, that treats the stretched stomach pouch or enlarged stomach outlet
Patient Criteria for Revisional Bariatric Surgery
Before a revisional bariatric procedure is performed, the patient will be examined by the bariatric surgeon to determine the cause of failure and to evaluate for the appropriate treatment options. Bariatric surgery is a very specialized and complicated treatment process that doctors approach carefully. Great care is given to maximizing weight loss success while minimizing risks and complications. The bariatric surgeon will need to determine if post operative weight loss failure is due to a problem with the original surgery or the patient’s inability to follow the necessary lifestyle changes. The doctor will want to discuss the options and what a patient should expect with the bariatric revision.
Results with a Bariatric Revision
Although the results can vary widely depending on the original procedure and the reason for the revision, bariatric surgery revisions are usually successful in resolving the associated problems and promoting further weight loss. Weight loss following a revision is usually not as dramatic as the initial bariatric procedure, but it can be substantial over time. As revision surgery can be more complex and involve more risks than general bariatric surgery, it is important to choose a bariatric surgeon that is experienced and skilled in performing revision bariatric surgery and that the operation is performed as a medical facility that is designated as a Metabolic and Bariatric Surgery Accredited Quality Improvement Program (MBSAQIP) facility.
As with all bariatric procedures, the best weight loss results are achieved by patients who are able to comply with the diet and exercise recommendations of their bariatric surgeon. The post-bariatric process can be a struggle and patients will benefit in their weight loss efforts by attending support groups, talking to a nutritionist for dietary advice, working out with a bariatric exercise program, and if needed talking to a psychologist to help deal with emotional aspect of obesity and weight loss surgery. Here at Alleghenies Surgical, we have a comprehensive team of dedicated weight management professionals that are here to help you throughout your journey.