Gastric Bypass Surgery is planned and intended for those who are suffering from severe obesity and it is considered as a convenient and effective long-term weight loss solution for who have struggled with all available weight loss options & dieting tips to reduce weight. Gastric bypass surgery is an elective procedure, it is imperative that you weigh both the risks, benefits , identify your weight loss goals and take basic medical advice before signing on for this life-changing procedure.
These surgeries are also known as the bariatric or obesity surgery. In this surgery the stomach size is reduced to the smallest possible extent. During the operation, the larger part of the stomach is detached and the intestines are reattached to the smaller stomach. People consider this procedure as a realistic solution to morbid obesity when traditional dieting has failed. In lots of cases, people feel that they are unable to follow dietary and exercise plans effectively ,as a result have not get the desired results and these procedures may simply fail to generate long-lasting weight loss results and weight regain can occur. It is not necessarily a patient’s fault but there can be a possibility of body not responding well to a particular obesity treatment. The reasons for the failure can be mechanical or metabolic. The reasons for surgical failure must be thoroughly investigated, and other causes can be ruled out, before it is attributed as a failure to adapt to a healthier lifestyle.
Possible Reasons of Failure
One of the most important reasons to seek revision weight loss surgery after failure of gastric bypass surgery is that there may have been complications in the first bariatric surgery.
Other factors can be metabolic reasons, failure to lose adequate weight & increased stomach capacity this happens when eating habits of a patient are not monitored well.
Gastric Bypass Surgery may fail for the following mechanical reasons:
- Gastro-gastric fistula– Gastro-gastric fistula is when the stomach pocket grows back and reconnects to the bypassed stomach. This can occur as a consequence of a pocket leak, where the resulting local irritation from the leak disrupts the staple line of the bypassed stomach.
- Pouch Dilation– It is a condition where the stomach pocket stretches out and enlarges.
- Anastomotic Dilation– It is a condition wherein the connection between the stomach pocket and the intestine stretches out.
Weight loss surgeries are performed very often now. Therefore, there are also a large number of individuals who experience unsatisfactory results. There are several medical issues that often complicate Gastric Bypass such as stricture, marginal ulcer and severe dumping Syndrome. Revision of Gastric Bypass is necessary to treat cases of malnutrition such as vitamin issues and mineral malabsorption.
What is Revision Weight Loss Surgery?
A Gastric Bypass Revision Surgery is performed on patients who have already undergone a bariatric surgery but have suffered from complications during the surgery. The surgery is also performed on people who have not completely benefited from the initial weight loss surgery. This procedure is performed on people who have undergone a gastric surgery and regained weight. Sometimes, it is also done in the form of an open surgery.
When Revision Surgery is Appropriate?
The most common reason why people consider gastric bypass revision is weight-related issues. Either you have not lost enough weight after the surgery or have gained back too much weight. Research studies show that up to 20% of patients who were morbidly obese and were suffering from obesity related health conditions . 35% of patients who were super obese have gained back more than 50% of their excess weight after 10 years. The Gastric Bypass Revision Surgery can carry risks just like your initial surgery. It is important that you will follow your surgeon’s orders exactly to avoid a second surgery.
Remove diet as the cause
- Coordinate with your dietitian to successfully monitor what you eat using a handwritten journal.
- Coordinate with your psychologist to determine any emotional issues to cause your diet or exercise goals fail.
Remove exercise as the cause
- A special device known as indirect calorimeter is used to test your Basal Metabolic Rate (BMR), which is the amount of energy your body burns while resting.
- Patients with an extremely low BMR (Basal Metabolic Rate) could have issues with weight loss even if pouch size and dietary habits are where they should be.
Once the diet and exercise problems are ruled out, your surgeon would like to check your stomach pocket size and the gap between your stomach and your small intestines. If it happens to be too large, it can cause post-surgery weight loss problems.
Some ways of checking it are as follows:
Upper Gastrointestinal Tract Radiography
Also known as Upper GI, this process will let you drink a special colored dye, during X-Ray procedure, in order to see your digestive area “in motion”.
During this process, the surgeon will apply a numbing spray or medication; the surgeon will pass a tube with a camera through your mouth, in order to indirectly estimate the size of your pocket and stoma.
During this medical procedure, your surgeon will estimate your capacity of food intake before feeling full.
Types of Gastric Bypass Revision Surgery
Adjustable Gastric Band
It is an inflatable silicone prosthetic device that is placed around the top portion of the stomach. It can be performed as a revision procedure for many patients who have had a previous Roux-en-Y gastric bypass surgery, gastroplasty procedure and stomach stapling.
During this process, a large portion of the stomach is removed, with the remaining portion is reshaped like a tube. This creates an increased sense of satiety and decreased hunger in patients, often leading to weight loss and hunger.
Roux-en-Y gastric bypass
It is a commonly chosen revision technique, particularly in patients who have not been able to meet their weight loss goals successfully such as gastroplasty, laparoscopic-adjustable gastric banding, vertical gastric banding and stomach stapling.
It is a complete endoscopic revision technique used to stiffen a stretched gastric pocket using internal stitches. It may be used in patients who have had a stretched stomach pocket and Roux-en-Y gastric bypass prior to StomaphyX.