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Gastric Sleeve Revision

Bariatric Surgery News & Research | Adelaide Bariatric Centre

12 Jan 2018 12:13 PM

Gastric Sleeve Review

What is Gastric Sleeve Revision?

If you have recently had gastric sleeve surgery and it didn’t meet your weight loss requirements, or even you gained weight after it, a gastric sleeve revision procedure could be a suitable solution.

Sometimes, people suffer from acid reflux after their sleeve surgery. This may also be an indication that a gastric sleeve revision may be suitable.

There are four options for gastric sleeve revision. They are listed here in the order of their efficacy in losing weight in the long term in most cases. Your doctor will recommend the most suitable procedure based on your medical history and personal circumstances.

1. Duodenal Switch (DS):

The Duodenal Switch is regarded as a challenging procedure and is generally only performed by experienced specialists. Here, in Adelaide Bariatric Centre, we offer this surgery as it is the most effective in the long term for most patients.

DS involves removing the excess part of the stomach if it has stretched out after the previous gastric procedure, removing the gallbladder and rearranging the small intestine as shown in the picture. This stretching is the most common reason that some initial gastric procedures don’t achieve the desired results

Caloric and mineral malabsorption can happen after this procedure, so controlling your diet is so important[1].

Gastric Sleeve

2. Gastric bypass:

Unlike the duodenal switch, mineral malabsorption can only happen in this case, so it is safer. All the same, you should discuss your diet supplements with your doctor to reduce any risks of these deficiencies.

Roux-en-Y Gastric Bypass (RNY) involves removing the top portion of the stomach and ligating the esophagus with the lower portion. Also, the jejunum is connected to the stomach and the intestine as shown here.

Roux-en-Y Gastric Bypass

3. Re-sleeve:

Re-sleeve is the most suitable surgical option in many cases when the stomach has stretched after a sleeve gastroplasty. However, like in sleeve gastroplasty, the stomach can re-stretch again without changes in eating and lifestyle habits accompanying the procedure.

On a positive note, re-sleeve is also the least invasive procedure among the surgical options of gastric sleeve revision.

4. Lap-band:

Many surgeons do not recommend this surgery as it has a high failure rate and can have uncertain results[2] for some types of patients. It involves banding the upper portion of the stomach with a ring that is connected to a tube to a small port under the skin as shown here. This port can control the size of the stomach entry part to control the amount of food required to fill the stomach.

Gastric Lap Band

Outcomes and advantages of Gastric Sleeve Revision

Gastric sleeve revision offers significant weight loss outcomes and prevents re-gaining weight after a sleeve gastroplasty.

Gastric sleeve revision also has an extremely low mortality rate.

However, patients should be aware that there can be more complications if there are any scars left behind the initial procedure. 

Who is Gastric Sleeve Revision most suitable for?

Patients who underwent a previous sleeve gastroplasty and who lose weight in an inadequate manner or even re-gain weight following their initial procedure.

Normally, if you underwent a sleeve gastroplasty, you should lose 70% of your excess weight in the 12 months that follow the surgery. If this doesn’t happen, call your surgeon immediately.

Preparing for your procedure

In order to have fewer complications after the surgery and to get a higher weight loss results after the surgery, safe and proper preparation for the procedure is recommended.

Prior to the surgery, you should eat a lot of protein to compensate your body for its needs after the surgery as you will go on a rapid weight loss. Also, taking multivitamins is recommended. Your doctors will be able to give you specific dietary recommendations to suit your individual needs.

The night before the procedure, you may be required to fast starting from the midnight to have a clear gastrointestinal tract.

You may also have some psychological, dietician and upper gastrointestinal evaluations to measure your preparedness and suitability for the surgery. Several common tests like blood work, electrocardiogram and x-ray are also likely to be required of you.

After your procedure

Like after your initial procedure, your diet will mostly consist of clear fluids like fruit juices. You’ll soon gradually transition from fluids to solid foods.

High protein and healthy diets are generally recommended after the surgery. Remember, our ultimate goal is losing weight.

In the first week following the surgery, you need to have someone to help you with your daily activities as sudden exertion or straining should be avoided after the surgery.

Ultimately, you may need four to six weeks for a full recovery after your surgery. 

Our multidisciplinary approach

Here at Adelaide Bariatric Centre, we offer you a multidisciplinary approach. The surgeons work closely with bariatric practitioners, dietitians, exercise physiologists, psychologists and bariatric nurses to help you lose weight.



[1] https://link.springer.com/article/10.1007%2Fs11695-017-2838-8

[2] https://link.springer.com/article/10.1007%2Fs00464-010-1250-4