Patients who regain weight after gastric sleeve surgery or develop complications such as acid reflux can benefit from bariatric revision surgery. The first is an endoscopic procedure to tighten a stretched sleeve. It is done by a laparoscopic endoscope that goes into the stomach without any incisions.
Weight loss with revision surgery is typically faster than primary weight loss procedures. However, the outcome largely depends on the patient’s diet and exercise routine compliance. Despite these challenges, patients can still lose weight with this procedure. Candidates for gastric sleeve revision are those who have experienced a plateau or increase in their weight following their original gastric sleeve procedure. They may also suffer from GERD symptoms or be unable to feel satiety with their food intake. If these issues are not resolved, the patient can experience a decrease in their quality of life and risk additional health problems.
Gastric sleeve revision is an endoscopic procedure that tightens the sleeve to its original size or smaller, similar to it after initial surgery. Your physician will use an endoscopic system passed through your mouth into the stomach to perform this treatment. The system is used to create several plications that make your stomach smaller without the need for external incisions. Depending on your goals, your doctor can convert your past sleeve to a gastric bypass or a duodenal switch. Studies show that conversions to gastric bypasses offer the highest levels of long-term success regarding weight loss and resolution of comorbidities.
Reduction in GERD Symptoms
Endoscopic revision of sleeve is often necessary for patients experiencing bothersome acid reflux and other GERD symptoms after their original procedure. Revision surgery helps these patients re-establish the sphincter function crucial to effective weight loss and relief of GERD symptoms. Revision to a gastric sleeve is also useful for those who have experienced stomach enlargement after the initial surgery. A gastric sleeve surgery can be re-calibrated with an endoscopic treatment called SIS (Sleeve Improved by Suturing). During a minimally invasive SIS procedure, the doctor will fold and stitch portions of the stomach to reduce its size, restoring the sleeve to its original shape and providing effective food restriction.
The re-sleeve surgery is usually performed as an outpatient under sedation. Usually, the operation is finished within an hour. Patients who have regained weight after their sleeve surgery may benefit from a surgical conversion to either a bypass or duodenal switch procedure. These procedures make a patient’s stomach smaller while adding a malabsorption component for better long-term results. It is an excellent option for those who regained weight after their initial bariatric surgery due to over-eating, poor diet, or other factors. It can be accomplished in various ways, including the gastric bypass or the sleeve with the duodenal switch as a staged procedure.
In a gastric sleeve revision, your doctor will use an endoscopic suturing device to tighten your stomach’s stretched pouch. This non-surgical outpatient procedure will help you keep your sleeve small, and you may even get to start losing weight again! Gastric sleeve revision is necessary for patients who experienced initial bariatric surgeries that failed to produce long-lasting results. It is because weight loss results will be impacted by overeating, which leads to stretching of the reduced stomach size. When this happens, it becomes harder for the patient to maintain a low-calorie diet and experience weight regain. The Lap Band, an adjustable silicone band placed around the top of the stomach to limit food intake, is a common case we see at our bariatric facility. A third of these patients require a gastric sleeve procedure because of complications, such as vomiting, heartburn and food intolerance due to a loosening or slipping of the band down the stomach wall. The most common revision procedure is to convert a sleeve to a gastric bypass. It is usually done if the patient has experienced inadequate weight loss or comorbidities, such as acid reflux or abdominal pain.
Reduction in Sleep Apnea Symptoms
Obstructive sleep apnea (OSA) happens when your throat becomes partially or completely blocked while sleeping. It causes long pauses in breathing, resulting in tiredness and a reduced quality of life. It is the most common type of sleep apnea and can be deadly if left untreated. OSA develops because your throat muscles relax while you sleep and obstruct the natural air movement into and out of your mouth and nose. It can also cause loud snoring, leading to high blood pressure and heart disease. People with obesity are at a higher risk for this condition, and fat deposits can obstruct the throat and reduce the airway size. A thick neck can also block the airway, like a deviated septum or enlarged tonsils. If you are overweight, your doctor may recommend surgery to help you lose weight. A less invasive treatment called a sleeve gastrectomy reduces the size of the stomach pouch. You will lose weight, and experience improved sleep when a sleeve works well. Some patients experience a loss of effectiveness or compliance with their sleeve and need to revise it to achieve better results. It is a simple process that involves tightening the sleeve by passing an endoscopic device through your mouth and throat without making any incisions.