Bariatric Surgery Revisions
While most patients find that their primary bariatric surgery allows them exceptional excess body weight loss and disease improvement over the course of the rest of their lives, some patients will not receive the results they expect long term and have some weight regain.
What Are Your Expectations?
First, it is important to adjust expectations, if necessary. Bariatric surgery is not a cure-all – rather it is a tool for patients to change their lifestyle and improve their chances of losing a significant amount of weight. But what is the appropriate measure of success? Objectively, losing 50-70% of excess body weight would be considered successful. Of course, this will fluctuate over time, which is perfectly normal. It is important to continue long term follow up with your physician as obesity is a lifetime disease process.
Could It Be A Lifestyle Issue?
We will then evaluate your diet and exercise program to ensure that the weight regain is not due to lifestyle issues. If lifestyle issues may be to blame, you will work with our staff and dietitian to get back on track. Often times, a small fix can help you get back on track.
If the above fails to change the weight regain situation, we will begin to consider options for revising the primary procedure. The most common revisions include:
Revising the Gastric Band
Gastric band surgery has shown a higher rate of long-term failure than stapled procedures and we perform many band removals. Fortunately, the band is fully reversible and the stomach remains completely intact after removal. This means that a band can be revised to any other procedure that the patient desires. Typically, we will perform a gastric bypass or gastric sleeve to replace the band.
Revising the Gastric Sleeve
A gastric sleeve revision is performed for weight regain, below expected weight loss, or significant reflux or heartburn. The most commonly performed revision of sleeve gastrectomy is conversion to the gastric bypass. This can help with further weight loss as well as allowing for significant improvement in heartburn. Other options including duodenal switch or redoing your sleeve can be considered.
Revising the Gastric Bypass
Gastric bypass revision can be more challenging. The revision options will depend upon your particular issue or anatomy. For a full discussion of possible revision options from gastric bypass, please feel free to schedule a consultation with Dr. Henke by calling or emailing us.