Revisional Weight Loss Surgery in NYC

Before a patient who has had prior weight loss surgery can qualify for a revision procedure, Dr. Jacob first has to ascertain what happened. Did circumstances in the patient’s life change and he or she returned to their former lifestyle and eating habits? It’s important to remember that weight loss surgery isn’t a cure for obesity; it requires lifestyle changes from the patient.

So, the first goal is to see if the patient can get back on track with exercise and nutrition. Others regain their weight due to anatomical reasons. For instance, their reduced stomach has stretched, allowing the person to eat more than was possible after their initial surgery.

In other cases, such as lap band procedures, the patient requires revision surgery because there has been a loosening or slippage of the band over time. For these patients, Dr. Jacob may perform a sleeve gastrectomy as revision.

There are a variety of factors that come into play when considering if a patient is a good candidate for revisional weight loss surgery with Dr. Jacob. During your consultation, the two of you will explore each of these.

Thanks to Dr. Jacob’s training and extensive experience with weight loss surgery, the results of his revisional surgeries are generally good. For complications, this means the complication is corrected and problems stemming from it are resolved. Weight loss following revisional surgery usually isn’t as great as with the original procedure. Some patients benefit from Dr. Jacob changing the original procedure.

For instance, some patients may have failed to lose the desired weight with a lap band procedure. Dr. Jacob could recommend a change to a gastric bypass procedure that could work well. There are risks with revisional weight loss surgery, so patients need to consider that. But when their weight loss from their original weight loss surgery wasn’t what they had hoped, these revisional procedures with Dr. Jacob can be very satisfying, changing the patient’s life and health moving forward.

These surgeries do present risk. The risks have lowered as surgical methods have continued to evolve. Twenty years ago, the overall complication rate from revisional bariatric surgery was near 50 percent. Those numbers have been improving, especially over the last decade.

The risks are both with possible surgical complications, such as chronic diarrhea or severe nutritional problems, and with unsatisfactory results. Overall, about 10 percent of lap band procedures have complications within the first two years. These include both issues with the band and unsatisfactory results. Gastric bypass surgery has a 5 to 10 percent rate of complication during the five-year period after the surgery, including the development of ulcers and unsatisfactory weight loss. The experience of your surgeon plays a key role in the success of revisional weight loss procedures. That’s where you can trust the training, expertise, and experience of Dr. Jacob.

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.

Because Dr. Jacob typically performs these surgeries laparoscopically, that makes for a shorter, easier recovery. Most people stay in the hospital for 2 to 3 days. You’re generally not allowed to eat for one to two days so that your stomach and digestive system can heal. Once home, you’ll follow a specific diet for a few weeks. This diet begins with liquids only, then progresses to pureed, very soft foods, and eventually to regular foods. You will have frequent medical checkups so that we can monitor your health and make sure everything is progressing normally.

These are permanent changes to the stomach. The goal is to get to the weight loss goals that the previous bariatric surgery failed to achieve. If the patient adopts a healthy lifestyle, including exercise and excellent nutrition, he or she will enjoy a leaner, healthier lifestyle for the rest of their lives.