July 15, 2020 | 6:30-8:00PM | Hackensack University Medical Center
Revisional Bariatric Surgery
What Is Revision Surgery?
Although most patients experience successful weight loss surgery, there are instances where revisional bariatric surgery is required. A revisional operation is used to correct one of the many types of weight loss surgery procedures that has failed due to inadequate weight loss or weight regain, unresolved comorbidities or unresolved complications.
Obesity is a chronic disease and not easily treated. As with any medical condition, if the first treatment is not effective, a bariatric revision procedure may be needed as an additional treatment for obesity.
Advanced Laparoscopic Associates (ALA) of New Jersey are one of the only practices in the area with bariatric surgeons experienced enough to perform these corrective procedures. Whatever your issue may be, there is a likely revisional solution to your problems.
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Robotics Revision Surgery
ALA uses the most advanced technology available to optimize successful results, such as robotic-assisted bariatric revision surgery. Although robotic-assisted revisions have been used as early as 1999, they are emerging as an additional method in bariatric revision surgeries, comparable to laparoscopic procedures.
Robotic-assisted surgery is still conducted by your surgeon. However, with the rise in more technically advanced revisions needing to be made, robotic-assistance is able to enhance the precision that the surgeon can provide. Utilizing magnified, high-definition and three-dimensional video technology, the surgeon works at a console with tiny instruments that transmit every hand movement into smooth maneuvers by robotic arms, enhancing dexterity.
Studies have been conducted in order to compare robotic-assisted revisions with laparoscopic revisions. Evidence suggests that in complicated revisional procedures, robotic-assistance may provide patients with a shorter postoperative hospital stay. A lower rate of complications such as leaks, strictures and hemorrhaging have also been seen when using robotic procedures.
Types of Revision Surgery
According to the American Society for Metabolic and Bariatric Surgery (ASMBS), revision surgeries can be divided into three main types.
- Corrective: This type of revision surgery is meant to fix problems with the original surgery.
- Conversion: Conversion surgeries convert one type of bariatric surgery into another.
- Reversal: Reversal revision surgeries restore the stomach anatomy to its original form (some types of bariatric surgery are irreversible).
How Bariatric Procedures Are Revised
Different bariatric procedures often require different types of revision surgery. Further, each revision is decided on a case-by-case basis. Obtaining accurate information about the initial surgery and existing anatomy is the key for a successful revision and keeping complication rates low.
Our bariatric surgeons will need to determine if the cause of the weight loss failure is due to a problem with the initial procedure or the patient’s inability to follow the necessary dietary and lifestyle changes. At ALA, our surgeons will review your old records and perform all the required tests such as an upper gastrointestinal study, endoscopy or others to choose the right revision procedure for you.
Common reasons for a revision surgery include:
- Bowel obstruction
- Fistula (a hole in the stomach or intestines)
- Gastroesophageal reflux disease (GERD)
- Inadequate weight loss
- Re-emergence of obesity-related conditions such as diabetes, heart disease or sleep apnea
- Weight gain
For specific types of weight loss procedures, here is how they are usually revised:
- Gastric band: Gastric bands are attractive because they are easily reversible; they can also be converted to gastric bypass, gastric sleeve or SIPS
- Gastric bypass: Usually corrective, as opposed to a conversion or reversal
- Gastric sleeve: Resleeve, converted to a gastric bypass due to weight gain or severe GERD or converted to duodenal switch
- SIPS: Usually corrective
Results of Revision Surgery
Revisional procedures are usually successful in resolving associated problems and prompting further weight loss. These procedures are generally done laparoscopically. While very safe, revision operations can be more complex and are usually slightly higher risk operations than first-time operations.
However, even with the slightly elevated risk of revision surgery, not performing them can be more dangerous. Health conditions that prompted the revision may get worse.
Although bariatric surgery is a safe and effective form of treatment for obesity, it is not a cure. Some weight regained after bariatric surgery is normal, but if the weight gain is extreme, a revision to a different type of procedure or a correction of the original procedure may bring the weight back down.
Recovery time will be similar to a first-time operation. According to a 2014 study in Journal of Gastrointestinal Surgery, hospital stays were slightly longer for a revision surgery than an original surgery. Weight loss results and total recovery time were similar.
If you need a revision surgery, don’t wait. Request an appointment with Advanced Laparoscopic Associates today. Whether you’ve developed a new health condition or just aren’t seeing the results you’ve expected from your bariatric surgery, we can help. One of our expert surgeons will determine the reason you need a revision surgery and the type you need, we will work with you to create a treatment plan that addresses your concerns and fits your lifestyle.
For additional information, all prospective patients are invited to attend a free educational seminar.
Seminars are a great source of information about the procedure you are considering, and they allow you to meet the surgeons as well as ask any questions you may have. You may also have the opportunity to meet some post-operative patients.