There might be an inside problem if you’ve been having trouble losing weight while following the advised nutrition and exercise recommendations. If this is the case, a sleeve revision might be a solution.
Gastric sleeve revision surgery is performed in an outpatient setting under sedation. It is speedy and safe.
Revision to Duodenal Switch
Patients who already have a sleeve gastrectomy but have problems losing weight or have uncomfortable symptoms like acid reflux might consider having a robotic revision. This surgery aims to change the sleeve into a gastric bypass or duodenal switch. Does gastric sleeve revision work? Both procedures have resulted in steady weight loss, improved comorbidities, and eliminated weight loss issues.
Unlike the gastric bypass, which involves rerouting the stomach and small intestine, the sleeve gastrectomy preserves the outlet muscle of the stomach (pylorus). It allows for a greater intake of protein and other vital nutrients. Additionally, it does not result in dumping syndrome, a nutritional deficiency illness marked by quickly emptying food into the small intestine following surgery.
The Duodenal switch surgery, also known as biliopancreatic diversion with duodenal switch or BPD-DS, effectively aids patients in losing weight by reducing food absorption and enhancing satiety. It starts with a vertical sleeve gastrectomy, made slightly more significant than when performed as a standalone procedure. The sleeve is then connected to the upper end of the small intestine, which is rerouted through the digestive tract’s lower end.
Bypassing a portion of the small intestine significantly reduces the absorption of calories and dietary fat, resulting in rapid weight loss. It also limits the amount of fluids and sugar absorbed from the large intestine, which can lead to bloating, flatulence, and mineral deficiency.
The surgery is typically done using a laparoscopic approach. It means the surgeon uses narrow tools through small “keyhole” incisions instead of a traditional open operation.
If you are considering a robotic revision of your adjustable gastric band, gastric bypass, or sleeve gastrectomy, it is crucial to weigh the pros and cons of each option carefully. You should also make sure you understand the potential long-term risks of your choice of surgery.
In the hands of an experienced bariatric surgeon, these procedures can yield excellent results and help you regain control of your health.
Revision to Gastric Bypass
Revision surgery to a gastric bypass is often recommended for patients who experienced poor weight loss or medical complications from their previous bariatric procedure. Unlike the initial bariatric surgery, this revision option can help patients lose the remaining excess weight they need to maintain their goal body mass index (BMI).
While sleeve gastrectomy is an effective and safe procedure with excellent mid- and long-term results, some patients may experience inadequate weight loss or develop bothersome symptoms such as severe acid reflux after their operation. The surgeon may recommend conversion to a gastric bypass or duodenal switch surgery in these situations.
The surgeon reseals and re-connects the stomach to the small intestine during a gastric bypass revision by creating a new surgical stoma. It is performed by dividing the first portion of the small intestine, connecting it to the stomach, and then surgically resealing the gastric sleeve. The result is a smaller, tube-shaped stomach restricting food intake and allowing fat malabsorption.
In some cases, the surgeon will also lengthen the Roux limb of the gastric bypass to add a metabolic component to the original restrictive procedure. It is a more complex and riskier procedure, but it can resolve anemia, dumping syndrome, severe diarrhea, or other problems associated with the previous surgical restriction.
Revision to a sleeve with a duodenal switch is typically performed as a staged procedure, with a sleeve gastrectomy being the first step. The sleeve is so small it doesn’t have enough volume to provide adequate nutrition. The duodenal switch procedure, similar to a traditional gastric bypass, helps patients overcome these issues by adding malabsorption of fat and other nutrients.
Revision to a sleeve doesn’t require hospitalization and is performed using an endoscopic tool. In this outpatient procedure, the stomach is accessed through the mouth using an endoscope, a tiny tube with a camera, and light at its tip. The doctor then uses the endoscope to suture the dilated stomach pouch, restoring it to its original size.
Revision to Vertical Sleeve Gastrectomy
While vertical sleeve gastrectomy is an effective weight loss procedure for many patients, some struggle with maintaining long-term success. Whether this is due to a lack of commitment to lifelong behavioral changes or an inability to follow their surgeon’s dietary guidelines, some patients will not achieve the desired results and may be looking for a way to improve their outcomes.
Revision surgery can be a solution for these individuals. These individuals can regain control over their weight reduction efforts and experience relief from medically untreatable conditions like acid reflux by addressing specific problems. These individuals have several revision options, including a re-sleeve operation, a re-sleeve with a duodenal switch, or a traditional gastric bypass.
The sleeve gastrectomy surgery aims to reduce stomach size so that only a tiny portion of food can be consumed simultaneously. While this approach is successful for many patients, some must have a gastric sleeve revision due to excess weight gain or the stomach stretching out. In this case, the doctor can perform a non-surgical procedure called suture resculpt or surgically reshape the stomach by removing or adding more tissue.
With a low rate of complications, sleeve gastrectomy revision can often be performed using minimally invasive techniques. During the procedure, an endoscope, a narrow tube with a camera and light on the tip, is inserted into the mouth to reach the stomach. The endoscope allows the doctor to view the dilated pouch and make necessary adjustments.
This method does not require hospitalization; most patients can return home within an hour of the surgery. In addition to its effectiveness, sleeve gastrectomy has significantly reduced health issues like type 2 diabetes and high blood pressure.
Revision to Roux-en-Y Gastric Bypass
In laparoscopic Roux-en-Y gastric bypass surgery, your surgeon changes the anatomy of your stomach by creating a smaller stomach pouch and connecting it to a lower segment of your small intestine. You’ll be able to consume less, aiding your rapid weight loss and long-term weight maintenance. The surgery also helps to address underlying health problems brought on by obesity, such as type 2 diabetes and high blood pressure.
This restrictive-malabsorptive therapy is potential for individuals who are very obese—those with a body mass index (BMI) of 40 or above or at least one weight-related health condition. It can be carried out using laparoscopic or open methods.
During this operation, your surgeon creates a smaller stomach pouch by reducing its size with surgical staples. Then, they connect the new pouch to a segment of your small intestine called the Roux limb. It restricts the amount of food you may eat and causes you to feel satisfied after only a modest amount.
You will need to adhere to strict meal plans following surgery.
While the surgery is safe for most people, complications can arise from any surgical procedure. They include infection, bleeding, leaks, and bowel obstruction. Infection is common and can be treated with antibiotics. Up to 3% of patients may experience bleeding, which is typically brought on by a ruptured gastrojejunal anastomosis. It can be treated with same-day laparoscopy or a T-tube placement. Bowel obstruction can happen early or late after surgery. A closed-loop obstruction, misidentification of the Roux and BP limbs, port site hernia, or small bowel volvulus can cause it.
In a 12-year study, bariatric surgery patients experienced substantial, durable, and sustainable weight loss and improvement in their comorbidities. While patients can regain weight over time, the average patient reaches their goal within a few years and maintains their new weight for 10 to 15 years.