Various surgical techniques are used to help patients with obesity overcome their weight problems. These techniques aim to facilitate a certain degree of weight loss and alleviate health issues associated with excess weight. Although the success rate of sleeve gastrectomy (tube stomach) surgery is high, there are cases where the results do not meet expectations and a second operation—known as a revision—becomes necessary.
Why Is a Revision Needed?
Complications after sleeve gastrectomy are among the main reasons a revision may be required. Causes of complications include factors such as lack of surgical experience and patients not following post-operative medical advice. Another reason is failure to achieve sufficient weight loss.
Even though bariatric surgical methods, including sleeve gastrectomy, reduce the stomach’s capacity, returning to old eating habits can lead to regaining weight. Initially, removing the section that secretes the hunger hormone (ghrelin) decreases appetite, but over time, appetite may return. If a patient cannot manage this renewed desire to eat, weight regain becomes highly likely.
What Is a Sleeve Gastrectomy Revision?
In simple terms, a sleeve gastrectomy revision involves correcting or adjusting a previous, unsuccessful tube-stomach procedure using a different surgical approach. The surgeon evaluates the patient’s situation to determine which bariatric technique is most appropriate for revision.
When complications arise after a sleeve gastrectomy, a revision may be necessary. Occasionally, proper management of complications can eliminate the need for a second operation. Common reasons for revision include:
- Failure to lose weight or regaining weight after initial weight loss.
- Post-surgery complications or secondary health issues that develop as a result of the unsuccessful operation.
- Structural problems in the stomach or intestines that hinder the passage of nutrients, especially in surgeries involving metabolic processes.
One frequently asked question is “When can a revision be performed after sleeve gastrectomy?” The timing is determined by your doctor. Typically, surgeons advise waiting 18 months if the motivation is insufficient weight loss. If significant weight loss hasn’t occurred during that period, a revision can be considered.
Expectations Before and After the Revision
The primary objective of revision surgery within the scope of obesity treatment is to help the patient lose weight successfully. During the procedure, the surgical approach may be changed. Additionally, other interventions may be performed to address ongoing or newly emerged health issues after the initial operation.
The Revision Process and Steps
The method chosen for a sleeve gastrectomy revision depends on the patient’s specific problems. It may involve repeating the same operation or opting for an entirely different procedure. Commonly performed revision surgeries include:
- Gastric Bypass
- Mini Gastric Bypass
- Duodenal Switch
- SADI-S (Single Anastomosis Duodeno–Ileal bypass with Sleeve)
Bypass operations are usually recommended for patients who experience reflux and weight regain together, or for issues like gastric rotation or narrowing. However, in certain cases, adjustments can be made without converting to a bypass.
- Endoscopic balloon dilatation or endoscopic sleeve stent placement may be tried for a narrowed stomach.
- If the fundus is enlarged and accompanied by reflux, removing the fundus or repairing a hernia may suffice.
- For significant weight regain, a bypass operation is often required.
- In cases of diabetes, transit bipartition or Roux-en-Y or duodenal switch are commonly used.
Recovery After Revision Surgery
Patients undergoing revision for weight loss should adhere to the surgeon’s instructions closely during recovery. The healing process is similar to the original operation. Typically, a hospital stay of 2–3 days is required. Returning to normal activities may take a few weeks.
During this time, it is crucial to follow the nutrition plan laid out by your doctor. This helps ensure proper healing and optimal weight-loss results.
Costs and Insurance Coverage for Sleeve Gastrectomy Revisions
The cost of revision surgery varies depending on the procedure details and the surgeon’s practice. Final costs are determined once the specifics are clarified. Many such procedures are covered by health insurance, provided the surgery is deemed medically necessary. Different insurers may impose special conditions for coverage, so verifying your insurance policy’s requirements is advisable.
Success Rate and Outcomes of Revision Surgery
A well-executed sleeve gastrectomy revision performed by an experienced surgeon typically yields positive results. One key factor influencing success is the patient’s commitment to the postoperative care plan, especially diet. Patients who failed to maintain weight loss after the original sleeve gastrectomy may face the same challenges if they do not strictly follow dietary guidelines. Potential risks of revision surgery include infection, leaks, and other complications that can arise during or after the procedure.
Choosing Your Hospital and Surgeon
Selecting the right hospital and surgeon is extremely important for a sleeve gastrectomy revision. Under the care of a skilled medical professional, complications are far less likely. In Ankara, Turkey, Op. Dr. Güven Görkem successfully performs revision procedures for patients who did not achieve their desired outcomes from a sleeve gastrectomy. If you are experiencing issues after your initial surgery or have failed to reach your weight-loss goals, feel free to schedule a consultation at our clinic.
