Revision Bariatric Surgery

Revision Bariatric SurgeryWhat is Revision Bariatric Surgery?

Obesity is a chronic disease. As such, there are reasons for which further treatment is necessary beyond a patient’s original bariatric procedure. These reasons include inadequate weight loss, significant refractory gastroesophageal reflux disease, ulcer disease, and band slippage, among others. Potential problems with a patient’s original procedure are the reason for lifelong follow-up. Patients experiencing excess nausea, reflux, abdominal pain, or problems swallowing food should see one of our bariatric surgeons to determine the cause.

Examples of revision surgery

Band removal is sometimes indicated for complications from laparoscopic adjustable gastric banding, including band slippage or erosion, inadequate weight loss, reflux disease, and band intolerance. This can be coupled with conversion to gastric bypass or sleeve gastrectomy.

Sleeve gastrectomy can be associated with an increased risk for refractory gastroesophageal reflux and therefore can require conversion to gastric bypass. Inadequate weight loss can also be a reason to convert to gastric bypass.

Gastric bypass can be complicated by ulcers at the connection between the gastric pouch and the small intestine (“marginal ulcers”). This risk is greatly increased by smoking and the use of nonsteroidal anti-inflammatory medications. When ulcers are recurrent and when the contributing factors are removed (smoking cessation, etc.), revision of the connection can be done.

Experience matters

Revision surgery can have a higher risk of complications, and therefore should be performed by experienced surgeons. Our surgeons have extensive experience with these problems; about 20% of the procedures they perform are revision surgery.

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