Revision Weight Loss SurgeryLast updated: Jun 24, 2013
What is revision weight loss surgery?
Revision (or corrective) weight loss surgery is a procedure to help correct problems associated with weight loss (bariatric) surgery.
The most common reason for revision weight loss surgery is insufficient weight loss after the initial weight loss surgical procedure. But patients also might need corrective weight loss surgery because they have gained weight or have complications from a first-time weight loss surgery.
Reasons for revision weight loss surgery include:
- Problems with anatomic changes of weight loss surgery, including:
- An enlarged gastric pouch opening, which can prevent weight loss and promote weight gain
- A large gastric pouch, which can prevent weight loss and promote weight gain
- An increase in intestinal absorption of calories, which can prevent weight loss and promote weight gain
- A slipped gastric band, which can cause nausea and vomiting or destroy stomach tissue
- The formation of an opening (or fistula) between the stomach pouch and bypassed stomach, which can prevent weight loss and cause abdominal pain, fever, and a rapid heart rate
- Leaking staple lines, which can cause abdominal pain, back pain, pelvic pressure, hiccups, fever, and a rapid heart rate
- Medical complications, including:
- Ulcers, which can cause pain, blood loss, nausea, and vomiting
- Scar tissue (stricture) that can build up and close important passages for food in the digestive tract
- The inability to absorb vitamins and minerals (malabsorption), especially vitamin D, vitamin B12, and thiamine needed for good health (malnutrition)
- Bone loss (or metabolic bone disease / osteoporosis) from absorbing too little calcium and other bone-building minerals
- The inability to absorb enough iron for good health (iron deficiency or anemia)
- Unresolved conditions, diseases, and disorders (comorbidities) related to obesity
Comorbidities associated with obesity can include high blood pressure, high cholesterol, heart disease, diabetes, respiratory problems, vascular problems, and genitourinary problems, among others. If you have had weight loss surgery and you are not losing weight and improving some or all comorbidities, your bariatric surgeon can recommend revision weight loss surgery options to help you achieve your weight loss and overall health goals
"Left untreated, some problems with anatomic changes, medical complications, and comorbidities after weight loss surgery can result in serious illness and even death," says Summit Medical Group bariatric surgeon Robert L. Bell, MD, MA, FACS. "For this reason, it is important to get regular checkups with your doctor and tell him or her about any symptoms you are having."
Types of revision weight loss surgeries include:
- Gastric bypass revision surgery
If you have had gastric bypass surgery and you are not losing weight, you are gaining weight, or you are having medical complications, your bariatric surgeon will first ask you to keep a food diary to ensure that the number of calories you are eating can help promote weight loss. If you are having medical complications such as a stricture, fistula, ulcer, dumping syndrome, or an enlarged stomach pouch that prevents you from eating to promote weight loss, your surgeon will discuss weight loss surgery options to help eliminate the complications and allow you to continue working toward your weight loss goals
- Lap band revision surgery
Lap bands that have slipped, eroded, or failed for any other reason require revision weight loss surgery. In some cases, it is best to remove the band altogether. Vertical sleeve gastrectomy is a revision weight loss surgery option that can help promote weight loss in patients whose lap bands have been removed
- Vertical banded gastroplasty (or stomach stapling) revision surgery
If you have had vertical banded gastroplasty and are not losing or are gaining weight, your procedure might need to be revised with newly placed staples and / or revised banding. Many vertical banded gastroplasty procedures, however, are converted to an entirely new procedure that can better promote weight loss
Whatever your unique needs, your bariatric surgeon can evaluate you and tell you which revision weight loss surgery options can help you achieve your goals for weight loss and overall health.
Risks of revision weight loss surgery can include:
- Longer surgery time
- Open incisions
- Blood loss
In addition, revision weight loss surgery does not guarantee you will lose as much weight as you lost after a first-time weight loss surgery. For these reasons, it is important to balance benefits of revision weight loss surgery with its risks.
It also is important to consider other factors that can strongly influence weight loss after a bariatric procedure, including life-long behavioral changes such as eating less food and fewer calories, making healthy food choices, eating very small meals, taking a small bite of food and chewing it thoroughly before swallowing, taking vitamin and mineral supplements as prescribed, exercising regularly, and getting regular medical checkups.