Bariatric surgery is a life-changing procedure that can produce dramatic weight loss and help treat weight-related health complications. However, some patients experience insufficient weight loss or complications following their weight loss surgery.
Fortunately, there are specialized surgical techniques that can improve these outcomes. These procedures, called revision surgeries, are designed to return the stomach pouch to its pre-surgery size and help prevent nutritional deficiencies.
How the Procedure is Done
Bariatric surgery alters the digestive system temporarily or permanently, limiting how much food can be ingested, reducing calories absorbed, and aiding in hunger control. This procedure can produce significant weight loss and help patients overcome health complications caused by obesity, such as type 2 diabetes and sleep apnea.
For those who have experienced significant weight regain following their initial operation or have developed unintended side effects, bariatric surgery revision may be able to provide the solution they are looking for. This type of surgery can help to correct unintended results from a prior operation, such as dumping syndrome (when foods that are high in sugar move too quickly into the small intestines), vomiting, nausea, and abdominal pain.
During a revision, the surgeon can reduce stomach pouch size by tightening the connection to the small intestines (known as the stoma). It is also possible to minimize stoma size after a gastric bypass to make the pouch smaller and repair a slipped band with LAGB or a ruptured band in RYGB patients.
Performing these procedures requires special training and a combination of skill, knowledge, decision-making, experience, and technology. Dr. Antanavicius and his team have the expertise to perform these complex surgeries using the most advanced tools. This allows them to offer a minimally invasive approach, which typically means lower risks, faster recovery, and shorter patient hospital stays.
What to Expect
You will need to make substantial changes to your diet and lifestyle. In addition to being careful about what you eat, you will need to exercise regularly, attend regular follow-up appointments with your bariatric surgeon, and participate in support groups. This multifaceted plan is necessary to ensure long-term success and prevent the weight from returning.
You may experience nausea following surgery, which can be managed with prescription or over-the-counter medications. Drinking plenty of liquids and apparent fluids like water and fruit juices is essential. This can help prevent dehydration and maintain electrolyte balance. If nausea persists, you may need to rethink your eating habits.
Wound infections can occur up to three weeks after surgery and are characterized by redness, warmth, pain, or thick drainage (pus) from the wound. These can be treated with antibiotics. Blood clots in the lungs, while rare, can be life-threatening and must be treated immediately.
To promote muscle strength, patients must avoid dairy products and high-fat foods and consume enough protein (60 to 100 grams daily). Constipation is expected due to reduced fiber intake but can be remedied by drinking plenty of liquids and adding a powdered fiber supplement to your diet.
It is also essential to use a reliable form of birth control, as fertility may increase with rapid weight loss. If you are pregnant, please let your bariatric team know as soon as possible.
Recovery
Bariatric surgery has proven to be a safe and effective method of helping people with morbid obesity lose weight and improve their health. However, it is essential to remember that this is not a cure for obesity, and it’s still necessary for most patients to work with their doctor on a long-term plan to maintain their desired weight loss. If you have experienced a significant amount of weight regain after your bariatric surgery or have not reached your weight loss goals, you may be a candidate for revision surgery.
If your previous bariatric surgery was a gastric bypass or a gastric sleeve, the connection between your stomach pouch and small intestines can enlarge over time. A revision procedure can tighten this connection again, helping you achieve the weight loss results you were hoping for with your original bariatric surgery.
Another reason you may need revision surgery is that your stomach pouch has stretched over time, which can reduce the amount of food you can consume at one time. During a gastric bypass revision, we can endoscopically reduce the size of your stomach pouch again to help you lose weight and reach your goals.
This clinic aims to provide specialized medical and surgical care for bariatric surgery revision patients. This includes a multidisciplinary approach to these patients, similar to the team of nurses, dieticians, and psychologists found in primary bariatric surgery clinics. A specific red flag system is used by each discipline to exclude patients who will not be successful with revision surgery.
Aftercare
Bariatric surgery is a powerful treatment that can produce dramatic results, allowing you to lose weight and overcome serious health complications like diabetes and sleep apnea. However, it’s essential to realize that this treatment doesn’t guarantee success, and some patients must undergo revision procedures due to complications or unsatisfactory weight loss.
The most common revision surgeries we perform are those of patients who initially underwent the Lap Band, an adjustable silicone band placed around the stomach to restrict food intake. About a third of those patients require additional surgery to maintain their weight loss goals because the band can slip or loosen over time and cause severe food intolerances. We can convert these cases to a gastric bypass or sleeve gastrectomy.
Patients who undergo bariatric surgery revision may need to stay in the hospital for one or three days after their operation. During this time, medical staff will monitor your condition and manage any pain you’re experiencing. Once stable, you can start slowly reintroducing solid foods, starting with clear liquids such as water or broth and moving to full liquids and, later, soft foods.
Generally, repeat surgery on the stomach is more complex than the original procedure because scar tissue can form between the stomach and other organs nearby, including the spleen and liver. Some of this tissue must be dissected free during the surgery, which can lead to injury and potentially dangerous complications.
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