Revisional surgeries (corrective surgeries) are specific types of surgeries performed for patients who have previously undergone weight loss surgery, such as sleeve gastrectomy or gastric bypass, but later experienced complications or did not achieve the desired weight loss results. The main goal of revisional surgery is to correct issues from the initial procedure and help patients return to a healthier path.
When Do We Consider Revisional Surgeries?
Revisional or corrective bariatric surgeries are usually recommended in situations such as:
- The initial bariatric surgery fails to achieve the expected weight loss.
- Patients continue to feel intense hunger or experience only minimal reduction in weight.
- Postoperative complications arise that require further surgical intervention.
- The patient did not follow the doctor’s advice and post-surgery instructions properly.
- The original procedure selected was not suitable for the patient’s weight or overall health profile.
- The surgery was performed by a surgeon lacking adequate experience or specialized qualifications.
- Weight regain after the first surgery.
- Technical errors during the initial procedure, or failure to comply with international standards set by the World Federation for the Surgery of Obesity.
- Development of complications such as persistent vomiting, digestive ulcers, iron deficiency anemia, or poor nutrient absorption.
- Enlargement of the stomach due to poor adherence to dietary and lifestyle guidelines after surgery.
What Are the Steps of Revisional Surgeries?
The exact steps vary for each patient and are based on a comprehensive evaluation by a specialist. This usually includes medical imaging, blood tests, and other diagnostic assessments to determine the best surgical approach.
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FAQs
When complications arise, if there’s inadequate weight loss, or in cases of failure of bariatric surgeries like gastric bypass (RNY) or sleeve gastrectomy.
After selecting the appropriate surgery and an experienced surgical team, the patient still has a vital role in ensuring the success of bariatric surgery and achieving an ideal weight safely, without complications — by strictly following post-operative guidelines and maintaining regular follow-ups with the doctor.
The patient should be careful not to underestimate the importance of adopting a healthy lifestyle and adhering to the diet and medical instructions recommended by the doctor. Neglecting these points may lead to stomach stretching once again, resulting in the failure of the surgery.
The bariatric surgeon carries the greatest responsibility for the success of the operation by taking all necessary precautions and measures to ensure a safe procedure without complications. These precautions include:
Performing a leak test in the operating room before completing the surgery to ensure there are no problems with the staples and no risk of leakage.
Preventing blood clots by administering anticoagulant injections, using compression stockings, and encouraging the patient to move within two hours after surgery.
Using the highest quality and most effective surgical tools, including the latest American staplers, and strictly following safety and quality standards before and during the surgery to prevent infections.
When correcting a gastric stapling procedure, a sleeve gastrectomy or either a full or mini gastric bypass may be performed.
The following revision options are also available:
For gastric band or ring corrections: the band may be removed, followed by either a sleeve gastrectomy or full/mini gastric bypass.
For sleeve gastrectomy revisions: the options include a re-sleeve procedure or conversion to a mini or full gastric bypass.
For mini or classic gastric bypass revisions: the surgery may involve repair and adjustment or conversion to another type of surgery, such as biliopancreatic diversion.
SADI-S (Single Anastomosis Duodeno–Ileal Bypass with Sleeve Gastrectomy).
Duodenal switch surgery.
The most commonly revised procedures are older gastric stapling and gastric band surgeries — and in many cases, these are corrected with a laparoscopic gastric bypass.
If the patient fails to lose the desired weight or the stomach stretches again after sleeve gastrectomy, possible solutions include revisional surgery in the form of a re-sleeve, converting to a different procedure such as mini gastric bypass, or other tailored approaches, all determined by a thorough clinical evaluation.
Yes, in cases of inadequate results or complications, gastric plication revision is sometimes possible, depending on individual circumstances.