As the most common weight loss surgery procedure performed today, Gastric Sleeve Surgery or Vertical Sleeve Gastrectomy (VSG) is highly effective and low-risk. Most gastric sleeve patients lose about 65 to 75% of their excess weight (EW) in the first two years and come to a healthy weight.
Unfortunately, no bariatric surgery is 100% effective for all patients, including gastric sleeves. Failure to lose enough weight or regain weight is uncommon; however, it occasionally happens due to improper diet, sleeve enlargement, hormonal factors, or a large pouch. Sleeve surgery must also be modified if the patient develops complications, such as intractable gastroesophageal reflux, strictures, or gastric leak.
One of the reasons that gastric sleeve is so popular is its many revisional options. Laparoscopic sleeve surgery can be easily re-sleeved or converted to RNY gastric bypass, mini-gastric bypass, and duodenal switch.
Mexico Bariatric Center® facilitates rescue and correction of previous weight loss surgeries in Tijuana, Mexico. MBC’s best weight loss surgeons have extensive experience revising failed vertical sleeve surgeries and getting you back on track.
How Revision Surgery Works
Is Revision Surgery Right for Me?
The gastric sleeve procedure is an acquired tool to help you lose weight; however, diet and exercise are equally important. If you have not been successful in losing all the weight, the lifestyle choice is normally impactful when it comes to weight loss surgery results. Here are things to consider:
Your Diet
Keep track of your daily diet as accurately as you can in a food diary. This would help your doctor and nutritionist to analyze your progress and find the right solution. If your diet is to be blamed, modifying that helps you avoid an unnecessary procedure. Try out the 5-day pouch reset diet.
Exercise
Eating less and eating healthier isn’t enough to lose excess weight and keep it off. Part of your post-surgery instruction is to get a moderate amount of activity as soon as your body has healed. Mexico Bariatric Center supports post-bariatric patients’ weight loss efforts by offering Nutritional Bootcamps.
What Does the Bariatric Revision Surgery Include?
The price of revision procedures in the U.S. and Canada without insurance can easily set you back $18,000 to $28,000. Fortunately, we offer U.S. quality weight loss surgery in Mexico at a fraction of the cost. We eliminate all of the planning and preparation by taking care of everything from the moment you arrive in San Diego to the moment you depart. Ground transportation, hotel stay, and everything in between is covered in our all-inclusive package.
Gastric Sleeve Revision to (RNY/Mini) Gastric Bypass
Revising a gastric sleeve to gastric bypass or mini-bypass is the most popular option available. The gastric bypass procedure adds a malabsorptive component that bypasses a portion of the small intestine while forming a small stomach pouch.
Advantages
- Adds malabsorption which limits food intake stored in fat cells
- Relieve Acid Reflux and GERD that worsened with gastric sleeve
- If the gastric sleeve is not effective, your body is more likely to favor the malabsorption of RNY/Mini Bypass
- Effective in reducing rates of obesity-related health issues like type II diabetes, and cardiovascular disease
Disadvantages
- Nutrient deficiencies require a daily vitamin/supplement regime
- Not likely to revise again after sleeve to bypass is completed
- Changes to anatomy due to bypassing (rerouting a portion of intestines)
Re-Sleeve Gastrectomy (Tightening)
In a few cases, the surgeon may also consider re-sleeving if the original sleeve was not done right. ReSleeve Gastrectomy (ReSG) consists of trimming a portion of the stomach that has re-expanded or not cut enough to create a smaller tube or sleeve.[4] Resleeve would be a viable option if the pouch is too large and/or the upper part of the gastric tube is dilated. Generally, the patient can tell if the restriction they felt earlier is gone and not feel it anymore. Research shows that two years after the sleeve operation, the volume of the stomach can double.
a) Laparoscopic Re-Sleeve
A good candidate for laparoscopic re-sleeve is a patient with correctable defects such as leaks and poor weight loss results. With the revision, thicker tissues are anticipated along the initial staple line from the original surgery. The surgeon will execute carefully calculated methods and will also; 1) Use a smaller bougie size and 2) Avoid creating an ischemic zone (the new staple line should be inside the old one). There is insufficient reliable data to know its long-term weight loss results and success rate.
b) Gastric Sleeve Revision with Mini-ESG
Patients with a dilated pouch with no reflux/GERD symptoms are good candidates for a miniature Endoscopic Sleeve Gastroplasty (ESG) revision. Mini endo-sleeve is a non-surgical procedure performed with a suturing device on the tip of an endoscope. The endoscopic plication device introduced through the mouth sews the gastric body to shrink and restores the original size of the sleeve gastrectomy. This restriction recreates the feeling of fullness with meals and enables further weight loss. This therapy can be done outpatient with no hospital stay required.
Gastric Sleeve to Duodenal Switch Revision
Gastric sleeve conversion to duodenal switch is a viable option but is a very aggressive one. The perk of revising sleeve to DS is that the first part of the DS is already completed with gastric sleeve surgery as the sleeve-shaped stomach is already in place.
The next step involves the surgeon performing a significant reroute portion of the small intestine to absorb fewer calories while eating and digesting food. Mexico bariatric surgeon also looks to tighten the original sleeved stomach if it is stretched and needs to be re-sleeved.
Gastric Sleeve with Adjustable Gastric Band
Adjustable gastric banding over a “failed” sleeve gastrectomy is an alternative but not recommended. The lap Band procedure used to be popular, but now it is known for its complications, risks, and failure.
Adding a lap band to an existing gastric sleeve is an option but rarely performed by most bariatric surgeons.
Banded sleeve gastrectomy using the GaBP Ring Autolock™ System to restore the sleeve restriction and prevent distal sleeve dilatation. The ring is only 1 cm, is not adjustable, and can cause erosion. GaBP system has not shown sustainable weight loss.
Bariatric Surgery Revision Before and After Photos
Success Rate of Gastric Sleeve Revision
Patients who had sleeve revision surgery due to inadequate weight loss experienced a significant decrease in body mass index (BMI), from 55.4 to an average of 35, and an average loss of 68.9 percent of excess body weight.[5] The outcome depends entirely on the revision surgery option and its effectiveness on the patient.
At Mexico Bariatric Center®, less than 5% of sleeve patients need a second surgery to get to their ideal weight. The most effective revision option has been converting gastric sleeves to mini bypass at MBC Tijuana surgical center.