Are you considering revisional surgery after having had an initial weight loss procedure performed? This guide will help you learn more about what’s entailed, what your options may be, and how you can get started.
The Tristate NYBG is a leader for revisional weight loss surgery, with more than 15 years of experience, while continuing to regularly perform the latest revisional procedures for our patients. Explore your options and get started here.
We recommend that any prospective patient first attend a Bariatric Revisional Surgery Procedures educational seminar. These seminars provide helpful information on all types of revisional weight loss surgeries, how they work, when they’re needed, and who they’re applicable for.
Beyond these seminars, we perform in depth direct consultations with any prospective revisional patient. During these consultations, we’ll walk through a number of factors which together will determine whether or not you should undergo a revisional procedure, and if so, of what variety. This includes:
You might need revisional surgery based upon one or several different factors discussed during our consultations. Determining the original type of surgery you had performed, and when possible, looking at your actual operative report, is an important beginning point.
Not all types of revisional surgery are viable options for all types of initial procedures. Additionally, those initial procedures have different success rates and complication risks which must be taken into account as well.
Speaking with patients about the postoperative instructions they were given is a crucial if oft overlooked factor. You may never have been properly educated and informed about how to adjust your lifestyle following bariatric surgery, dooming you from the start. In this case, education and support can circumvent the need for revisional surgery, even for those already past the initial golden period of very rapid weight loss.
We’ll also look at your weight loss history. If you never lost weight, as opposed to regaining weight after opening success, the most likely answer is that there was a technical error with your initial procedure. Additionally, any complications you experienced, such as infections, prolonged vomiting, ulcerations, and more, may have affected your success.
The revisional procedure which is best for you will depend upon the initial procedure you went. It’s worthwhile to understand how these procedures work and in turn what may need revision.
For gastric bypass surgery, results are produced via malabsorption due to the changes to your intestinal track, but primarily through restriction with the small stomach pouch and narrow stoma which were created. It’s here where long term problems are possible due to either dilation of the stoma, or stretching of the pouch.
To correct this, several options may be at your disposal. This includes endoscopic procedures such as ROSE and Apollo, along with Band Over Bypass.
Starting with the former, the range of endoscopic revisional bariatric surgery began with StomaphyX, which has now been phased out in favor of the ROSE and Apollo procedures. StomaphyX was a breakthrough when it was first available, however, long term success was low and the procedure was deemed to be not durable.
With Band Over Bypass, a lap band is utilized over top of your existing bypass. The lap band can now reverse and control the stretching of your stomach pouch, or the dilation of your stoma. This is a popular and effective option. It is not as minimally invasive as endoscopic procedures though, as it does require abdominal incisions.
Sleeve gastrectomy functions via the creation of a 120 cc vertical tube or sleeve using a line of stomach staples. If results aren’t as expected over the long term here, similarly to gastric bypass procedures, stretching of the sleeve is the likely issue.
What is unique in the case of sleeve gastrectomy is that one of your revisional choices will actually be a repeat of the original procedure. However, it’s important to note that stapling over the original staple line adds a higher risk of complication to your procedure.
An alternative is the Band Over Sleeve. Like the Band Over Bypass, a lap band is utilized over top of your initial surgery, reversing and controlling the stretching which had occurred. This is popular, successful, and carries a lower risk than a repeat sleeve gastrectomy.
If you originally underwent lap band surgery, then you’re familiar with the need for ongoing adjustment, control and fine tuning of the lap band in order to maintain results. As opposed to either the gastric bypass or vertical gastric sleeve, no permanent physical changes were made via surgery to your body.
Therefore, your two revisional options are actually to undergo one of those two initial procedures, gastric bypass or gastric sleeve. In the case of gastric sleeve, it’s recommended for those who initially saw success with the lap band, whereas gastric bypass is typically recommended for those who never truly saw results, as well as diabetic patients. Each procedure carries its own unique set of advantages.
Deciding to undergo revisional weight loss surgery is of course a very serious process, and it’s essential that you are thoroughly familiar with the options, and the risks.
Finding an experienced, seasoned surgical team is crucially important, particularly with the added risk of complication with a revisional procedure. Additionally, finding the support of a comprehensive bariatric program such as the one the Tristate NYBG provides is very important as well. Proper education, ongoing assistance and follow-ups, support groups, mentors, and more will be at your disposal and are proven to enhance your long term weight loss results.
When you’re ready for revisional surgery in New Jersey, we’re here to help. Call us at 800.633.8446 and we can schedule a consultation appointment or answer your questions.
If you are ready to lose weight, you have many options at our Tristate Bariatric Group. We combine surgical expertise, patience, compassion, and the confidence to lead you through the journey to successful weight loss.
