Revisional Surgery Checklist

 

  • Incidence of weight regain is 10 – 15%
  • Options:
    • Reset: Diet, Nutritionist, Exercises, UGI, EGD
    • Medical Weight Loss
    • Surgical Revision:
      • Band: Sleeve or Bypass
      • Sleeve: Re-sleeve, Bypass, SADI S
      • Bypass: Lengthening

Revisional surgery is becoming more and more common with approximately 10-15 % of bariatric operations now involving some type of revisional surgery. Older operations such as Gastric Banding have gone out of favor and been replaced with new more effective procedures such as the Gastric Sleeve. Other factors responsible for weight regain are non-adherence to dietary plan, lack of sufficient exercise, stretching and dilatation of the upper gastric pouch, and development of an abnormal connection between the upper and the lower gastric pouches.

It is important before jumping to new procedure that we understand the reason for the weight gain. The first option is a RESET: We start as though you were a new patient. Are you following the proper diet? We have you consult with our nutritionist. Are you following some regular pattern of exercise consisting of cardio and weights? We may also perform a UGI (Upper GI X-Ray) and or Esophagogastroduodenoscopy, or EGD for short. To make sure there are not any anatomical issues that are contributing to your problems.

In some case patients can even benefit from non-surgical medical weight loss program to help you kick start renewed weight loss. This a one-on-one physician-supervised program that may include meal replacement products to cut calories and improve satiety, weight loss medications, including appetite suppressants, to encourage weight loss (depending on individual needs).

If after exploring these other options, you are still not able to lose the weight we can consider a surgical solution.

  • For those with a Gastric Band: Either a Gastric Sleeve or Gastric Bypass would be excellent revision for you.
  • If you have a Gastric Sleeve: We can consider a Re-sleeve, or a Gastric Bypass, or even a SADI S which offer more greater malabsorption in addition to restrictive properties of the Gastric Sleeve.
  • Finally, if you have a Gastric Bypass: We can consider a “lengthening” procedure.  We take part of the intestine and move it further down to increase the benefit you are receiving from the malabsorption.