What is a Revision Surgery?

Weight loss surgery helps people struggling with their weight to shed those extra pounds. While the operations have seen high rates of success, some patients may not receive the results they desired from the surgery. They may not notice enough weight loss, regain weight soon after their surgery, or face other medical complications. In such cases, patients can undergo a revision weight loss surgery.

What is a Revision Surgery?

A weight loss revision surgery or revisional surgery is performed to reverse, correct, or re-do a previous weight loss surgery that did not yield desired results. The surgery may be performed for one or more of the following reasons.

Not Following through with lifestyle changes

Patients do not always take the best care of themselves. Bariatric surgery should be followed with a healthy diet and exercise plan, but some patients are not able to follow through.  Some patients have a hard time getting enough protein in, so they fill up with slider foods which are not filling and tend to have more empty calories.  So, they regain the weight they had lost and may even gain more. In such cases, they may have to undergo a revision surgery to kick start their weight loss again or to find a procedure that works better for them.

Problems with the Surgery

It is possible that a patient’s surgery can fail for a variety of reasons. This can happen if the surgeon did not create a small enough pouch, so that the patient does not feel restriction when they eat.  In such a case, patients will see less than optimum results and should consult another surgeon.  Some surgeries, like the gastric band, were meant to be a temporary solution.  After years, they can create issues like erosion, slippage or pouch dilation and could require removal of the device.

Medical Needs

Some bariatric surgeries have to be reversed because the patient develops certain health issues that must be addressed. Some issues include but are not limited to: intolerable reflux symptoms, gastric stricture or uncontrolled diabetes. These concerns may vary from one patient to another and should be dealt with on a case-by-case basis with the surgeon.

Types of Revision Surgeries

Gastric Band Revision Surgery

Sometimes after a gastric band surgery, the device can slip, erode, or fail altogether. If the surgery does not lead to weight loss, then the best course of action is to remove the band. In such cases, the patients should opt for a band to sleeve or a band to bypass surgery.  The procedure involves removing the device, repairing any damage, then converting to a gastric sleeve or gastric bypass.  This can be done in either one surgery or two surgeries, depending on the damage and the surgeon.

Gastric Bypass Revision Surgery

If a patient doesn’t see the desired results after a gastric bypass surgery, the surgeon typically asks the patients to maintain a food diary to keep a tab on their calorie intake. They may also ask them to get checked for ulcer, fistula, or any other complication that may lead to an enlarged stomach pouch. Depending on the results, they will either help you to correct your course or perform a revision surgery. Typical gastric bypass revisions can be done by endoscopic suturing to reduce the size of the pouch, or a distal gastric bypass, which relocates the pouch to lower in the intestines.  Different surgeons offer different options

Gastric Sleeve Revision Surgery

If a patient isn’t feeling any restriction or isn’t losing weight after their vertical sleeve gastrectomy, they may opt for a revision to their procedure.  With the gastric sleeve revision, they are multiple surgical options available.  One option is for the surgeon to go back in and create a new, smaller sleeve.  This can help if the pouch was never small enough or if the stomach has stretched.  Some surgeons will suggest a gastric sleeve to gastric bypass, where the sleeved portion of the stomach is shortened and converted to a bypass. Another option is to convert to a Doudenal Switch or DS. The sleeve remains attached to the top of the small intestine, the duodenum, which is then separated from the rest of the small intestine. It is then attached to the lowest part of the small intestine.

To Revise or Not

Nobody plans on a revision surgery. After all, it does lead to extended surgery time,  risk of infections, and other complications. However, revision surgeries may be absolutely necessary in some cases. In other cases, they can be avoided by following the prescribed diet and exercise programs after the first weight loss surgery.  Make sure that you find a surgeon who has plenty of experience in revision surgeries, as these are more complicated that initial weight loss surgeries (insert link to our bariatric surgeon search)

Related Articles