Tristate NYBG has a renowned team of surgeons and support staff with more than 15 years of experience performing revisional weight loss procedures. Revisional surgery is performed after an initial procedure for patients who have regained initial weight loss, stopped losing weight, or never saw desired results.
It’s important to learn more about your options, along with why you may need revisional bariatric surgery, what the process is, and what the risks of revisional surgery are.
Before undergoing a revisional procedure, you’ll first meet one on one with one of our highly experienced surgeons. This consultation is utilized to learn more about you and your procedure, while determining potential courses of action we can take.
Your consultation will involve numerous factors. This includes determining the initial type of surgery you had, along with when and where you underwent your surgery.
We’ll also discuss the initial postoperative care and lifestyle instructions you were or were not given, your weight loss history following the procedure, and any complications which occurred.
this, which is why our in depth consultations are so important. Here, we’ll expand on the factors outlined above.
The type of surgery you underwent is of course important for any potential revisional procedure. To begin, different revisional options are available based upon the initial surgery. Additionally, success rates are different for different procedures. When possible, we will look at your original operative report as well.
Many patients fail to see the results they desired not because of technical error or complication but due to poor education, information and assistance. We need to learn more about the postoperative instructions you had to see if weight loss failure was due to poor instructions and a lack of proper lifestyle adjustment, such as maintaining the right nutritional intake. In this case, revisional surgery can often be avoided in lieu of refining your lifestyle.
Looking at your weight loss history helps to shed light on the potential for technical surgical error or problem. If you never lost any weight, then that’s certainly the most likely scenario.
Finally, looking at any complications you may have experienced may help to explain why weight loss was influenced. Complications such as infections or ulcerations, amongst others, may have affected your ability to lose weight successfully over the long term.
In addition to our direct consultations, we also offer educational seminars on Bariatric Revisional Surgery Procedures. These will explain different procedures and options and who they’re designed to help. We recommend that prospective patients first attend one of these seminars.
Different revisional procedures are available for different initial procedures. In the case of gastric bypass surgery, the success of the procedure relies on two mechanisms — restriction via the creation of a small stomach pouch and a narrow stoma, along with malabsorption via the changes to your intestinal track.
A revisional procedure is required when the restrictive component of your initial surgery has failed. Via endoscopy, we will evaluate your stomach and see if this is due to either a stretching of the stomach or dilation of the stoma.
Your options for gastric bypass revisional surgery include endoscopic surgery, and Band Over Bypass.
Endoscopic surgery actually has several different procedures, including ROSE and Apollo. Together, those two options have largely replaced StomaphyX, which was proven to be not durable. StomaphyX, though, was at first a breakthrough in revisional surgery. Performed endoscopically, it required no incisions and was minimally invasive. However, long term results were not as expected.
Band Over Bypass utilizes a lap band actually placed over your gastric bypass. This has been proven to be effective and is an increasingly popular choice with our patients. It can reverse and control the effects of both stretching and stoma dilation. While incisions are required, making this slightly more invasive, Band Over Bypass is highly successful.
Sleeve gastrectomy is a newer procedure than gastric bypass which has been shown to be just as effective as gastric bypass, while offering a less invasive initial procedure. Yet, here too, results can taper off or fail to reach desired levels. Similarly to the gastric bypass, this may be the result of stretching, in this case, the stretching of the 120 cc vertical sleeve which had been created.
Here, the sleeve gastrectomy can actually be repeated as one revisional choice. This requires stapling over the original staple line which had created your sleeve. This does entail a higher risk of complication compared to other revisional procedures.
Alternatively, Band Over Sleeve is another revisional choice. Band Over Sleeve lowers the complication risk as it does not involve that re-stapling procedure of repeating the sleeve gastrectomy, and it works to reverse and control the stretching of the sleeve which was the cause of the problem.
In order to be and continue to be effective over the long haul, the lap band must be adjusted and fine-tuned over time. For patients who originally chose the lap band, revisional surgery actually entails the removal of the lap band and a choice of undergoing either gastric bypass or gastric sleeve.
Gastric sleeve is typically recommended for patients who initially saw positive results with lap band surgery. Gastric sleeve leaves your intestinal tract intact, and is less invasive than gastric bypass.
Gastric bypass, on the other hand, is recommended for those who never saw success with the lap band, or patients who are diabetic. It has a proven 40 year record of results, producing weight loss via both restrictive and malabsorptive components.
By its very nature, revisional procedures entail higher risk of complication and a higher level of technical challenge. That’s why it’s so important to find an experienced and recognized surgeon or clinic to work with.
Additionally, having the right type of ongoing support and assistance has been proven to have a huge impact on the long term success of patients. Tristate NYBG offers an unmatched bariatric program which guides you to success through each step of your journey.
Whether you’re ready to get started or you’re looking for more information on revisional surgery in Pennsylvania, you can take the first step by calling the expert team at Tristate NYBG at 800.633.8446.
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.
