Revision or Failed Weight Loss Surgery

Bariatric surgery is a successful tool to combat obesity and weight gain. However, some patients may need a secondary or revision procedure to address problems that occur or to achieve their desired weight loss goal.

Indications.

There are several reasons why a patient may need revision surgery including:

Inadequate weight loss.

Weight regain.

Persistent obesity-related illness.

Complications after weight loss surgery.

Your doctor will review your case thoroughly to identify the reason for failure. Successful bariatric surgery requires patient compliance in terms of diet and lifestyle changes. If you need help in these areas, an exercise program or appropriate therapy will be recommended. If the original procedure was inadequate or complicated, your doctor will discuss treatment options best suited to your specific condition.

Pre-procedural instructions.

You are instructed to avoid eating or drinking after midnight before surgery. Ask a family member or friend to be with you at the hospital for support and comfort. Specific instructions will be given depending on the surgery being performed.

Surgical Procedure.

Bariatric procedures commonly performed include gastric bypass surgery, sleeve gastrectomy and lap band surgery. These procedures may need revision for reasons such as enlargement of the stomach pouch, slippage of the gastric band or complications such as malnutrition, vomiting, hiatal hernia or ulcers.

Revision surgery may include repair of tissues, repositioning of the gastric band, placement of an adjustable gastric band, or conversion to a distal gastric bypass. Alternate procedures such as StomaphyX, which creates stomach folds or plications to make the stomach pouch smaller or duodenal switch surgery may be more effective in achieving weight loss.

Post-Operative Care.

Postoperative procedures and instructions will vary depending on the type of surgery performed. Most patients will need to take some time off work and rest for several weeks to enable healing. Typically, you will have to return to your post-gastric surgery diet of liquid and pureed foods for a few weeks. It is important that you are committed to your exercises and other lifestyle changes to achieve your weight loss goals. Talk to your doctor if you need assistance in these areas so the appropriate education and care can be provided.

Risks and complications.

Failed weight loss surgery can be extensive and may be associated with certain risks such as blood loss, the need to convert to open surgery with a large incision, infection and gastric leakage.

Weight loss revision surgery is recommended to promote further weight loss or resolve complications from prior bariatric surgery. The initial weight loss you experience following revision surgery may not be as dramatic as your initial surgery, but with patience and resolve, the effects of revision surgery will become apparent.