Revisions Surgery

Revisions Surgery

Weight loss surgery for morbid obesity is complex as a first procedure. Revision surgery becomes even more complex because of scar tissue and the alteration of normal anatomy from the original procedure. All obesity surgery procedures CAN be revised. Not all SHOULD be revised. The key to revision surgery is being as certain as possible that the goals are clear and that the benefits outweigh the risks. To do this we need to gain as much information as possible related to the initial weight loss surgery procedure so that it can be evaluated for the reasons for failure. There can be many reasons for failure. Some reasons are mechanical and surgical. Some are not. It is important to differentiate which is the case prior to proceeding because statistically, revision surgeries have a higher risk of complications than original procedures. The weight loss associated with all revision surgeries varies from the losses seen from the original procedures.

THE FOLLOWING THINGS ARE NECESSARY FOR EVALUATION:

  • The type of the original procedure performed (gastric sleeve, gastric bypass or lap-band), including a copy of the operative procedure note if possible (may be obtained from original surgeon’s office, or usually the facility where the procedure was performed).
  • History of weight loss- starting weight, lowest achieved weight, maximal weight lost, approximate rate of regain.
  • Office Consult- for physical evaluation, discussion of goals.
  • Upper Endoscopy- to evaluate the stomach and esophagus to define the current anatomy (preferred to be done by us to assess options).
  • Nutritional assessment- to assess current state of health, choices and habits.

Options Include

NON-SURGICAL OPTIONS
  • Nutrition monitoring/ mentoring
  • Nutrition monitoring/ mentoring
  • Coaching
  • Behavioral Management
  • Physical Fitness Options
  • Acupuncture

BAND OVER GASTRIC BYPASS
  • Revision Gastric Bypass with Pouch Reduction
  • Revision Gastric Bypass with Gastric Outlet Revision
  • ROSE Procedure
  • Reversal of Gastric Bypass
  • Reversal of Gastric Bypass with Conversion to Biliopancreatic Diversion
SURGICAL OPTIONS
  • Lap Band Revision
  • Lap Band Revision with Hiatus Hernia Repair
  • Lap Band Port Removal with Replacement of Low Profile Form
  • Lap Band and Port Removal
  • Lap Band and Port Removal with Conversion to Gastric Sleeve
  • Lap Band and Port Removal with Conversion to Gastric Bypass

REDO SLEEVE GASTRECTOMY
  • Conversion Sleeve Gastrectomy to Gastric Bypass
  • Conversion Sleeve Gastrectomy to Biliopancreatic Diversion