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If you struggle to lose weight despite following your post-op diet guidelines, it may be time to consider gastric sleeve revision surgery. Many can perform this procedure safely and quickly through an endoscopic technique.
Patients who have experienced sleeve gastrectomy complications like reflux or difficulty swallowing can also benefit from this step-up surgical pathway. Options include conversion to a gastric bypass or duodenal switch, which are both highly effective.
What Is A Sleeve Gastrectomy?
Gastric sleeve surgery is a type of bariatric weight loss procedure for those with severe (class III) obesity or who have other health conditions that are related to obesity. The average person who undergoes sleeve surgery loses 25% to 30% of their total body weight in the first year or two.
This procedure is performed with minimally invasive surgical techniques. The surgeon creates a thin, elongated stomach pouch that occupies about 1/3 of the stomach volume. After this operation, patients must commit to a lifelong change in eating habits and exercise. It is also recommended that patients seek out nutrition and psychological counseling before the surgery to help them prepare for their new lifestyle.
Those who undergo sleeve gastrectomy should expect to have a long-term relationship with their surgeon, as they will need to attend regular appointments for ongoing follow-up care. During these visits, gastroenterology specialists like Dr. Gary Richter will monitor your weight loss results and your symptoms to ensure you benefit most from the procedure.
If you are experiencing poor weight loss results or have developed complications like reflux or difficulty swallowing, your doctor may recommend a sleeve revision surgery. This can involve converting the sleeve into a traditional gastric bypass, a re-sleeve, or a sleeve with a duodenal switch.
How Does A Sleeve Gastrectomy Work?
While a gastric sleeve is not reversible, many patients can lose much weight with this procedure successfully. However, it is not a permanent solution, and a person must commit to healthy diet changes to maintain their results. Sometimes, a patient’s stomach will stretch out again, and they may experience regained weight or gastric reflux, which can lead to a need for gastric sleeve revision surgery.
This operation involves removing about 75 percent of the stomach and turning it into a narrow sleeve tube. Food must be eaten very slowly, and the sleeve allows only a tiny amount of food to pass into the small intestine. Over time, this causes a person to feel full much quicker and consume less food.
If a patient has experienced a complication or has failed to meet their weight loss goals, a surgeon can perform two types of sleeve revision surgery:
So, does gastric sleeve revision work? A sleeve gastrectomy revision involves tightening the sleeve, which is done with an endoscopic device that passes through the mouth. The doctor can make the sleeve smaller or convert it to a re-sleeve, a duodenal switch, or a traditional gastric bypass. A re-sleeve involves shrinking the stomach and readjusting the pressure pouch, while a re-sleeve with a duodenal switch adds a malabsorption component to the surgery.
What Can I Expect From A Sleeve Gastrectomy Revision?
You may need a sleeve revision if you’ve had gastric sleeve surgery and are no longer losing weight, despite following your surgeon’s dietary and exercise guidelines. Other reasons to undergo sleeve revision include experiencing post-surgical complications, such as acid reflux and difficulty swallowing.
One type of sleeve revision procedure is the endoscopic sleeve gastrectomy tightening policy, a brief same-day outpatient operation that restores fullness and satiety through a surgically created stomach pouch. This is a good option for patients who regained weight after having sleeve gastrectomy because they could eat more significant portions and lose control of their eating habits.
Another sleeve revision procedure is the conversion of vertical sleeve gastrectomy to a duodenal switch (GDVS). Your bariatric surgeon will create a smaller stomach pouch by folding the more extensive section of your stomach up and stitching it together. Your doctor will then connect this pouch to the lower portion of your intestine so food passes directly through the gastrointestinal tract, reducing calorie absorption.
A sleeve revision is also a good option for patients who underwent Lap Band surgery, an adjustable silicone band placed around the top of your stomach to restrict food intake. About a third of these patients now require sleeve or gastric bypass revision because their bands have loosened and no longer provide adequate restriction.
How Can I Prepare For A Sleeve Gastrectomy Revision?
A gastric sleeve revision might be correct if you struggle to lose weight after a sleeve gastrectomy. This procedure is designed to help you regain control of your life and your health. Many patients experience weight recovery even when they follow their surgeon’s recommendations. Your body may be unable to lose the weight you need to improve your health.
A few different gastric sleeve revision procedures are available, depending on your specific circumstances. One option is converting your sleeve to a gastric bypass or a duodenal switch. This is typically best for patients experiencing a lack of weight loss and bothersome digestive issues like acid reflux.
Another option is a less invasive surgery called sleeve revision via endoscopy. This involves accessing the stomach through your throat and using an endoscopic sleeve gastroplasty procedure to smaller the stomach pouch. This will help you eat less food, usually performed using the same technique as your original surgery.
Finally, the most common gastric sleeve revision procedure is a sleeve-to-bypass conversion. This involves removing more of the stomach, creating a smaller “walnut-sized” stomach pouch, and then attaching it to the lower portion of the intestines to reduce calorie absorption. This is more suited for patients experiencing weight gain and digestive problems such as GERD or dysphagia.
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