Gastric Sleeve Revision Surgery

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 the gastric sleeves. Failure to lose weight or regain weight is uncommon but occasionally happens due to improper diet, sleeve enlargement, and hormonal factors. Sleeve surgery must also be modified if the patient develops complications, such as 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 converted to RNY gastric bypass, mini-gastric bypass, or 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.

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.

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 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 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.

Adjustable gastric banding over a “failed” sleeve gastrectomy is an alternative but not recommended. Lap Band used to be popular, but now is known for its complications, risks, and it’s a failure. Adding a lap band to an existing gastric sleeve is an option, but rarely performed by most bariatric surgeons.