What is Revision Surgery?
Revision surgery is a term used for the surgeries performed for treatment failures and the health problems caused by the previous obesity surgeries. Although it is often performed in cases of inadequate weight loss or weight regain, it may also be performed in cases of severe reflux disease that may be seen after surgery.
Who can have revision surgery?
There are some criteria for revision surgery to be performed especially due to inadequate weight loss or weight regain. These criteria are for the patient to lose less than 50% of their excess weight after the first surgery or if it is to be performed due to weight regain, they should regain more than 50% of the weight lost after the surgery. Revision surgery is performed after at least 2 years the first surgery. Other than the technical problems in the first surgery regarding inadequate weight loss or weight gain, the issue of patients’ avoiding their post-operative responsibilities and repeating the mistakes leading them to obesity should definitely be assessed. Therefore, revision surgeries are more disadvantageous than the first surgery in terms of treatment success. It should be considered that a patient who has failed once may make similar mistakes again.
What are the revision surgery types?
Today, revision surgery is performed after the adjustable gastric banding (gastric band) which is no longer used due to the insufficient success in the treatment. Revision surgeries may also be performed after sleeve gastrectomy and gastric bypass surgeries. In some cases, technical failures in the first surgery can be recovered in revision surgery or the first surgery can be transformed into another type of bariatric surgery due to the technical incompetence in the first surgery. To illustrate, gastric bypass surgery can be performed to a patient who had a failed sleeve gastrectomy for a second time, or to a patient who gains weight again after sleeve gastrectomy, although there is no expansion of the stomach after sleeve gastrectomy. Also, the adjustable gastric banding can be revised after surgery as sleeve gastrectomy or gastric bypass surgery. The most technically difficult revision surgeries are gastric bypass surgery revisions. Weight loss can be achieved by changing the intestinal leg lengths, which are disregarded in gastric bypass revisions.
Surgical treatment is the most effective method in the treatment of obesity and obesity-related diseases today. The need for revision surgery is also increasing depending on the increasing number of surgeries. Each surgical method has its own failure rate that requires revisional surgery. Revision surgeries may be required due to inadequate weight loss, weight gain or side effects related to the surgical method after the surgery. Revisional surgery is more difficult and complex than the first surgery. Complication rates are also proportionally higher than initial surgeries. Therefore, surgeries should be performed in centers providing service in this field with experince
