What is Bariatric Surgery Revision?
Have you had a previous weight loss surgery and experienced problems, complications, or not losing the weight expected? About 15% to 35% of bariatric patients cannot reach their goal weight and require intervention. Patients must rule out diet and exercise problems before proceeding with another procedure.
Poor weight loss is normally influenced by age, diabetes, hypertension, depression, pre-operative BMI, dietary lifestyle, activity level, previous abdominal surgery, and type of surgery.
Mexico Bariatric Center® offers various solutions to revise your prior procedure into one that may prove more effective. These procedures include:
- Revising unsuccessful surgeries like gastric sleeve, gastric bypass, or mini-gastric bypass.
- Reverse obsolete procedures like lap-band, gastric plication, and vertical banded gastroplasty.
Fill out a health questionnaire to find out your favorable revisional opportunities.
Bariatric Surgery Revision Before and After Photos
Amy – Gastric Sleeve to Mini Gastric Bypass Revision
Gastric Sleeve Revision
If laparoscopic sleeve gastrectomy (LSG) fails to produce sufficient weight loss, many patients opt to go with the RNY Bypass, Mini Bypass, Duodenal Switch, or have a re-sleeve. A patient’s clinical history will often tell if a patient’s current sleeve is ineffective. These three revisional options should work to increase the amount of expected weight loss:
- Gastric Sleeve to Gastric Bypass – Following our patients’ progress, we’ve found sleeve to bypass or mini-bypass to be the most effective weight loss revision.
- Gastric Sleeve to Duodenal Switch – Biliopancreatic diversion with a duodenal switch is a definitive procedure for effective weight loss.
Re-Sleeve – This procedure is suitable if the sleeved pouch is severely stretched or not performed right in the initial operation. The re-sleeve can be done laparoscopically and, in some cases, endoscopically (mini-ESG).
Vertical Sleeve Gastrectomy failure can be caused by the following:
- Improperly sized sleeve
- Stomach stretching
- Patient’s body adjusting to lower caloric intake
Gastric Bypass Revision
If roux-en-y gastric bypass fails to produce desirable weight loss, or if patients lose too much weight, revising to another surgery type could be necessary. Although gastric bypass is considered semi-permanent, patients can be switched to various options, including a duodenal switch. A Lap-Band can also be placed around the stomach to help induce weight loss. Other bypass revision options include:
- Shrink the stoma by injecting a sclerosant (“sclerotherapy”)
- Reduce the Size of the Pouch laparoscopically
- Reduce the gastric outlet endoscopically (TORe)
- Add Lap-Band around the stomach (lap band surgery)
- Lengthen the Roux limb
Gastric Bypass Failure can be caused by the following:
- Pouch enlargement
- Staple-line disruption
- Stoma enlargement or failure
- Patient’s body adjusting to lowered caloric intake
Karla – Gastric Bypass Revision Surgery
Leoni – Lap Band to Gastric Sleeve Revision
Gastric Banding (Lap-Band) Revision
Increasing consensus is the dissatisfaction with gastric banding as a tool to treat obesity. More and more patients are experiencing insufficient weight loss and undesirable complications. The most common revisional surgery is Lap-Band to Gastric Sleeve. The gastric sleeve provides the restriction familiar to Lap-Band patients but also includes suppression of appetite. A list of revisional surgeries includes:
- Re-Adjust Lap-Band Placement
- Lap-Band to Gastric Sleeve
- Lap-Band to Gastric Bypass
Statistically, ten years post-op, 60% of all lap band patients no longer have their lap band. Lapband failure can be caused by:
- Erosion
- Slippage
- Pouch enlargement
- Poor access to adjustments
- A certain percentage of patients do not lose weight with Lap-Band
Vertical Banded Gastroplasty (VBG) Revision
Vertical Banded Gastroplasty, or stomach stapling, is an outdated weight-loss procedure that uses stitches and an implant to achieve weight loss. Developed by Dr. Edward E. Mason, the developer of the original Gastric Bypass in 1966, it was originally developed in 1980. Since that time, long-term studies over ten years have shown disappointing results.
Compared with other surgery options, Vertical Banded Gastroplasty doesn’t produce significant weight loss and can allow patients to regain their weight. Another possible reason for weight loss failure is the lack of duplicate stitching (a practice that is now standard), which can tear or open. When this happens, patients must convert to another surgery. Most stomach stapling procedures have been performed via an open incision, making the revision operation technically difficult.
Surgeries VBG can be revised to:
- Gastric Sleeve Surgery (Likely)
- Gastric Bypass Surgery (Less Likely)
Patients with weight loss surgery must also factor in their personal genetics. Certain individuals are merely designed to store fat and several years after weight loss surgery, their bodies adapted to the malabsorption component and lowered caloric intake, and patients begin to gain weight slowly again.
Benefits of Revising a Failed Surgery
For any procedure that failed due to complications or insufficient weight loss, revisions, conversions, and reversals may be a great option. Associated surgical problems include fistula, staple line leak, or slipped gastric band. Associated medical problems include ulcers, scar tissue strictures, or the inability to absorb vitamins and minerals.
Risks of Weight Loss Surgery Revision
Patients considering revision surgery must also be aware that the second surgery has almost a 50% higher rate of complications than the first one. Human tissue forms adhesions in response to any disturbance, such as surgery. Adhesions vary from person to person and have no bearing on the external scars on the skin. Bariatric re-operative surgery takes much more operating room time and skill because of the careful dissection of layers of adhesions.
Risks common with correctional surgeries are leakage, the necessity to revise a laparoscopic surgery to an open operation, incisional hernia (from open surgeries), bleeding, etc. With all revision surgeries, there is always a risk with anesthesia; this can be minimized by using a surgical team with extensive knowledge in bariatric surgery.
Bariatric surgeon has to deal with scar tissues and altered blood supply from the previous time surgery.
Great strides have been made in the field of trans-oral surgery (surgery via an endoscopy procedure). While this area is still very experimental and in its infancy, this type of surgery may offer a low-risk alternative in the future to repair enlarged stomas and other types of reoperations.
Mexico Bariatric Center Revisional Case Studies
Mexico Bariatric Center® works with an exclusive network of the best bariatric surgeons in Tijuana who have the expertise and experience revising and reversing outdated, unsuccessful, or botched primary bariatric surgeries. To name a few, revision of Lap-Band®, Gastric Sleeve, Roux-en-Y Gastric Bypass, VBG, etc.
Patients who had conversion surgery due to inadequate weight loss experienced a significant decrease in body mass index (BMI), from an average of 55.4 to an average of 35, and an average loss of 68.9 percent of excess body weight.[5] The outcome depends completely on the revision surgery option and the effectiveness it has on the patient.
At Mexico Bariatric Center, less than 4% of sleeve patients need a second surgery to get to their ideal weight. Converting gastric sleeve surgeries to mini bypass at MBC Tijuana surgical center has been the most effective update option.
Success Rate of Bariatric Surgery Revision in Mexico
At Mexico Bariatric Center, we inform patients about all the options and success rates so that they are able to make educated decisions for themselves. MBC’s Tijuana surgeons have extensive experience in rescuing botched and goofed-up surgeries. Consult our specialized multidisciplinary revision center in Tijuana and Guadalajara, Mexico, to help you see which correctional surgery fits you best.
Andrea – Bariatric Revision Surgery
Sherry – Bariatric Revision Surgery
* Prices are subject to change. Not valid on certain dates (blackout dates). Prices depend on the surgeon, surgery, additional fees, and schedule. Prices may rise because of BMI level and previous abdominal surgeries.