Gastric Bypass Revision Options
Gastric bypass re-intervention is performed if you have already had an unsuccessful or botched gastric bypass procedure.
The RNY conversion is more complex and as a result a riskier procedure than the primary bariatric surgery. However, if the revisional operation is performed by an experienced and skilled surgeon in a dedicated bariatric surgery hospital, it carries less risk.
The type of revision is chosen depending upon the cause of adverse effects. The following procedures are effective for losing weight after gastric bypass failure occurs:
1. Shrinking the Stoma
The first option for gastric bypass revision surgery is to shrink the stoma. This is done with an injection called sclerosant, in a procedure known as sclerotherapy. Sclerosant is made up of sodium correlate and is injected into the stoma, which is the space between your stomach and small intestine. If the problem with your procedure were the dilation of your stoma, this injection could help. Usually, it requires 2-3 injections over a period of time.
In the August 2007 issue of Gastrointestinal Endoscopy, there was a study performed on potential weight gain after bariatric procedures It found that the average patient who got these injections lost at least ten more pounds in 6 months. There are minor complications possible, including abdominal pain, bleeding, and small ulcers.
Incorporating the Lap-Band® to the Roux-en-Y gastric bypass is a revision alternative. Adjustable Gastric Banding (“Salvage Banding”) is useful in patients in which gastric pouch dilatation is the reason for gastric bypass failure.
In lap band surgery, a small adjustable silicone band is placed at an upper end of the stomach to reduce stomach size. This procedure is performed with laparoscopy by small incisions on the abdomen that heals quickly. If performed in a properly selected person, it results in excessive weight loss over months.
3. Reduce the Pouch Size
StomaphyX is an endoscopic suturing system used to reduce the size of the enlarged stomach pouch and stomach outlet (stoma).
If your doctor finds that the size of your pouch is too large, they may do so with either a ROSE or StomaphyX procedure. Both of these tighten your stomach with tubes going down the esophagus, so they are minimally invasive.
The ROSE procedure, which stands for revision obesity surgery endoscopic, uses a simple method for narrowing your stoma. It costs between $8,000 and $13,000. The StomaphyX is another option and works in a similar manner as the ROSE procedure. This is also $8,000 to $13,000.
Distal Vs Proximal Bypass
4. Lengthening the Roux limb
This process takes your original proximal Roux-en-Y gastric system and converts it to a Distal Roux-en-Y procedure, with a longer Roux limb. It is typically only done on patients that show a low BMR and lack of weight loss, regardless of their dieting and fitness regimen.
This procedure has the most risks, including a 15 percent chance of leaking, according to a study in the February 2008 issue of the Department of Surgery.
5. Duodenal Switch Surgery
Duodenal Switch is an excellent revision bariatric surgery procedure for the majority of patients who have gastric bypass failure. In this procedure, a small banana-shaped stomach is created, and two parallel limbs of the small intestine are formed.
Food passes through a separate channel and juices of the liver and pancreas are drained through another channel. This procedure does not allow the mixing of food with digestive juices so, little absorption of ingested food, and the patient loses weight quickly.
* Currently, Mexico Bariatric Center is not accepting patients for Gastric Bypass to Duodenal Switch Revision.