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Revisional Surgery

Bariatric Surgery News & Research | Adelaide Bariatric Centre

26 Apr 2018 10:39 AM

Revisional

What is revisional bariatric surgery?

Revisional bariatric surgery is another surgical treatment following a previous bariatric surgery which did not lead to the desired results.

In most cases, revisional procedures are performed laparoscopically, which means that it is relatively non-invasive and low-risk. Only in very rare cases will laparoscopic revisional surgery need to be converted to an open surgery if we think that it is the safest way to complete the procedure.

When is revisional surgery appropriate?

A small percentage of bariatric surgery patients will experience less than expected results, such as less weight loss than desired or some weight re-gain.

There are several possible reasons for these outcomes. The most common is diet choice – which our dieticians and clinical psychologists can help with – but other common reasons may be stretching of the stomach (or a portion of the stomach) or lap band movement. A revisional procedure may also be used to convert one type to bariatric procedure to another.

You should also know that not everyone is suitable for revisional surgery. You may be a candidate for revisional surgery if:

  • You have a BMI 40 or above.
  • You lost less than 50% of the weight you planned to lose after your initial bariatric procedure.
  • You regained some or all the weight you lost after your initial bariatric procedure.
  • You have regained enough weight to cause further health problems such as diabetes to return or occur.

As every case is different a complete evaluation of the medical history, lifestyle, treatment preference, and reasons why you gained the weight back should be evaluated.

What are the advantages of revisional surgery?

The greatest advantage of revisional surgery is to achieve the positive weight loss and health outcomes of the original bariatric procedure as safely and non-invasively as possible

With revisional surgery of previous weight loss surgery, a variety of problems or complications can also be addressed such as intractable ulcers, intractable reflux, deteriorations of the stomach wall, infections, staple – line failures, movements of the gastric band, erosions of the gastric band or strictures.

What are the risks of revisional surgery

Any bariatric procedure including gastric band, gastric sleeve, or gastric bypass can be revised. The revisional procedure is performed on the same part of the abdomen as the first and there is a possibility of encountering scar tissue. For this reason, there is a greater risk of complications occurring after the second surgery.

However, this does not mean that a revisional surgery does not have a good outcome. In most cases, revisional surgery successfully treats the complications of the initial bariatric procedure and the desired weight loss is achieved. Generally, patients will lose less weight after the revision surgery compared to primary bariatric surgery.

How to prepare for revisional surgery

Preparation for revisional surgery will depend on the exact surgical procedure that is going to be performed. It is important to carefully consider and evaluate the reasons why the initial surgery did not lead to the desired results.

You should always keep in mind that the process of losing weight with bariatric surgery is a challenging process that requires a certain period of time. If a patient hasn’t made the necessary dietary and lifestyle changes after their first surgery, then it is unlikely that a revisional surgery will be successful either.

A multidisciplinary approach is necessary when preparing for revisional surgery. At Adelaide Bariatric Centre the surgeons work closely with dietitians, psychologists, bariatric practitioners, bariatric nurses and exercise physiologists when helping you achieve your goal of losing weight.

After the procedure

Revisional surgery can be more technically challenging than an initial procedure. It is also associated with a higher risk of complications. The recovery period is normally longer than the first surgery and you may need to remain in hospital for two or three days after the procedure.

However, the recovery period at home is usually just the same just as with an initial bariatric procedure. In general, you will need a couple of weeks before resuming to your normal daily activities.