A gastric bypass revision is a form of surgical procedure which is done on patients who have already gone through bariatric surgery. The process is conducted if in case the patient has had complications brought about by the surgery. One of the main reasons why a patient would have to undergo this kind of revision is when the initial surgery was not successful wherein the patient was not able to lose weight.
This type of medical procedure is done usually laparoscopically which is a form of MIS or minimally invasive surgery while some patients may have to undergo open surgery in cases wherein extensive scarring has occurred after the initial surgery. Weight loss procedures or surgery are becoming very popular but there are also a few cases wherein the patients are not fully satisfied with the results which may lead to bypass revisions.
Types of revision surgery
Convert to duodenal switch: This form of revision surgery is best suited for patients who are extremely obese or those who have a BMI of 50 or more. This type of procedure is proven to be a better alternative or revision since many studies have showed the positive results of duodenal switch.
Lap band surgery: This form of gastric bypass revision can be achieved by simply adding an adjustable gastric band. Several studies have been conducted with this kind of surgical revision and have shown better results on patients who have not have been successful with their initial surgery.
Injecting a sclerosant which can shrink the stoma: The stoma is the opening between the small intestine and the stomach and injecting a sclerosant or sodium morrhuate can be the most effective way to treat stoma dilation. This type of gastric bypass revision may be more effective compared to the other forms of revisions but there are certain complications that a patient may experience such as small ulcers, bleeding, abdominal pain and even blood pressure elevation.
Lengthening of the roux limb: This type of revision is best for patients who have a low metabolic rate which does not help in their weight loss program. This medical procedure converts the Roux-en-Y gastric bypass to the distal Roux-en-Y gastric bypass in which the former is the most conventional form of gastric bypass surgery.
Pass a device through the mouth going to the pouch to make it smaller: This is a relatively new procedure wherein the stomach is re-tighten without incisions. This is a better alternative for patients who do not want to undergo another invasive procedure since special tubes are just inserted through the mouth going down to the esophagus and then to the stomach pouch which can create permanent folds around the stoma and also within the pouch.
When is a revision appropriate?
The usual reason why patients would want to undergo a revision is when they are not able to lose weight or they might have gained too much weight after the surgery. Recent studies have shown that more than 20% of morbidly obese patients have gained their weight back after the surgery. This can be a result of a few internal issues which should be determined by a doctor.