Weight loss surgery isn’t always successful. Sometimes the former procedure fails, such as when a lap band loosens. In other cases, the patient failed to lose the expected weight. Revisional weight loss surgery may then be necessary.
Dr. Jacob performs these revision procedures.
What is revisional weight loss surgery?
In revisional bariatric surgery, a second procedure is necessary to modify or repair an earlier operation. The reasons for revision are varied, such as failure of a lap band or sleeve, or the patient may have a disappointing outcome.
Dr. Jacob performs these revision surgeries for two reasons:
- Poor weight loss or the patient has regained the weight
- Complications of the first procedure, which are specific to the type of procedure performed
How is revisional weight loss surgery performed?
These revision surgeries vary with the original procedure. Dr. Jacob starts with a thorough review of why the patient’s original procedure failed. Causes could include a displaced port with a lap band, a ruptured band, or a stretched remaining stomach in a Roux-en-Y gastric bypass, among others.
The most common revisions derive from patients who previously had a lap band. These were very popular procedures up until just a few years ago, but now about one third of these patients require revision to address loosening or slipping of the band, which has affected their ability to lose the weight they want. For these patients, Dr. Jacob will likely recommend a change to a sleeve gastrectomy or a gastric bypass.
Unlike a lap band, which is placed around the top part of the stomach to restrict food intake, in a sleeve gastrectomy Dr. Jacob removes a portion of the stomach. Rather than the original stomach, the patient now has what looks more like a vertical sleeve. This limits the amount of food necessary to feel full because the stomach size has decreased.
In a gastric bypass, the stomach is also made smaller by bypassing a large part of it. Dr. Jacob divides the stomach into an upper pouch and a large lower portion that is meant to be bypassed. The small intestine is then connected to the upper pouch. The stomach is now smaller, and the procedure also changes hormones that affect the patient’s appetite. It’s these hormone changes that go beyond weight loss to also effectively reducing diabetes.