Bariatric surgery is an excellent tool for weight loss, but sometimes it is necessary to revise the surgical procedure. These revisions address medical and nutritional complications following your original weight loss surgery.
A common revision is converting a VBG to RYGB, which involves removing the band and bringing a loop of the small intestine up to the stomach pouch. This is considered the most complex revision procedure but carries the highest successful weight loss and comorbidity resolution rate.
Weight Regain
Gastric bypass surgery is highly effective and helps most patients lose weight. However, some patients regain weight after following their doctor’s advice about exercise and diet. If you’re finding that your efforts are not producing the results that you need to maintain a healthy weight, there may be some signs that you need a bariatric revision procedure.
You might need a gastric bypass revision because your stomach pouch or sleeve is stretched due to eating behaviors or gastric surgery complications. A common complication is an enlarged connection between the pouch and the small intestines called the stoma. In this case, your surgeon can reduce the stoma size by tightening the connection.
You might also need a gastric bypass revision if your Roux limb (the middle part of the small intestine that connects to the stomach) is leaking or too short. This problem occurs when the stoma is too big or the stomach pouch is stretched out, leading to food loss and regaining weight.
Surgical Complications
Gastric bypass surgery is known for helping patients lose triple-digit percentages of their excess weight within the first year. However, it is common for patients to regain some of this lost weight over the next few years. In many cases, this regain can be reversed by following strict diet and exercise guidelines. However, if the regain is too much, surgical correction options are available to help people get back on track with their bariatric surgery success.
If a patient has regained a significant amount of weight, they may need a gastric bypass revision to reduce the size of the stomach pouch. This procedure typically uses minimally invasive techniques and requires very little recovery time. The goal is to make the stomach pouch smaller, allowing the patient to reach a state of satiety sooner with meals and increase their overall weight loss efforts.
It’s also possible for the connection between the stomach pouch and small intestine (called the stoma) to stretch after gastric bypass surgery. In this case, the surgeon can use a minimally invasive procedure called endoscopic gastropexy to tighten the connection. This procedure aims to prevent the stoma from stretching too far, which can lead to weight gain and other medical complications such as severe acid reflux disease or bowel obstruction.
Nutritional Issues
When you have gastric bypass surgery, the small pouch your surgeon created in your stomach limits how much food you can eat and prevents you from absorbing calories. But if you’re having trouble losing weight or your body isn’t getting the nutrition it needs, there are solutions like changing your diet or taking supplements.
Sometimes, the outlet connecting your stomach pouch to your small intestine can stretch and enlarge. This may lead to increased calorie intake and weight gain. Your surgeon can help by using a tube inserted through your mouth and endoscopic instruments to place stitches in your stomach to reduce its size or tighten the outlet.
Some people have difficulty digesting dairy foods like milk or yogurt after surgery. This can cause bloating, cramps, and diarrhea. You can try lactase pills or switch to dairy-free products.
If you’re experiencing weight loss problems that can’t be solved by changing your diet or taking supplements, your doctor may suggest a gastric bypass revision. This relatively new procedure changes your stomach pouch to a duodenal switch. It’s less invasive than other procedures but still a surgical procedure with risks and complications. Following your doctor’s instructions after a gastric bypass revision is important to maximize the benefits and minimize the drawbacks.
Psychological Issues
Gastric bypass surgery is a major weight loss procedure that can help most patients lose a significant amount of weight and maintain healthy body weight. However, it is not a cure for obesity. In many cases, patients must make lifestyle changes and follow post-op guidance from their bariatric surgeon to continue losing weight. A gastric bypass revision may be needed if these steps are not followed.
Sometimes, the stomach pouch holding the food can stretch over time and lose its restrictive effect. If this happens, a patient will find it difficult to lose more weight and might struggle with food retention, vomiting, or abdominal pain. This can feel devastating for a patient who has spent much money on weight loss surgery and committed to a healthier lifestyle to lose the excess weight they want.
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Several surgical options are available for patients who need a gastric bypass revision. Some of these procedures are less invasive than others. For example, an endoscopic gastroscopy can remove the enlarged stomach pouch or adjust the connection between the stomach and the small intestine. A sleeve gastrectomy is another option that can restore the restrictive effect of the stomach. Another more complex option is converting from a Lap Band to a duodenal switch, which offers restriction and malabsorption to promote long-term weight loss.
