Gastric re-sleeve suitability - Can I expect 100% ghrelin removal and 80-90% stomach removal?

Question

Follow-up question - I had gastric sleeve abroad as had low BMI (27). The highest BMI I have ever been is 30. The operation went smoothly but disappointed to learn surgeon removed 65% stomach & 80% ghrelin. I am now looking to re-sleeve but my BMI IS 25. Would a surgeon operate on me ? Pls note my ethnicity increases the risk of health issues with a BMI of 23 or more and I have pre-existing auto-immune condition. and can I expect 100% ghrelin removal and total 80-90% stomach removal

Reza Keshavarzi, MD, FACS, FASMBS · Answer

100% ghrelin removal isn't possible. Ghrelin (the hunger hormone) is made in several parts of the body, not just the stomach. A sleeve gastrectomy does lower ghrelin levels significantly, but complete removal cannot be achieved through surgery.
80–90% stomach removal is typical in a first-time sleeve gastrectomy. If your original surgery removed only about 65% of your stomach, a re-sleeve could potentially remove more. However, the benefits must be weighed carefully against the risks &mdash; especially with a BMI as low as 25.
Important to know:Since your BMI is already in a normal range, and you have other health factors like an autoimmune condition, a second surgery might not be the best choice. It’s important to have a full evaluation with a bariatric specialist to explore whether a re-sleeve is necessary or if non-surgical options would be safer and more effective.

Ali Solmaz, MD · Answer

With a BMI of 25, you may still be eligible for a re-sleeve surgery, especially given your unique health circumstances. While many guidelines set a BMI of 30 (or 27 with health issues) as the threshold, your situation is different. Your ethnicity increases your risk of health issues at a BMI over 23, and you have a pre-existing autoimmune condition. Both factors may qualify you for surgery under medical necessity.
Since your first procedure removed 65% of your stomach, a re-sleeve could further reduce its size, potentially reaching a total removal of 80-90%. While complete ghrelin removal is unlikely since most of it was already reduced by 80%, further reduction may be possible depending on the remaining stomach structure.
Surgeons experienced in revision surgeries are more likely to consider cases like yours, especially if you emphasize your medical risks, existing symptoms, and health goals.

Walfre Edwin Guerrero Burgueno, MD · Answer

Your BMI is too low to be a candidate for bariatric surgery, even for the first time or for revision. According to international indications, you do not have the requirements.
But on the other hand, you can keep good control of eating habits with a nutritionist, emotional support with a psychologist, and the use of weight loss medications could even be evaluated, but revision bariatric surgery (resleeve) definitely not.

Islam Abdelkhalek, MD · Answer

Your BMI is not suitable for resleeve. To do revisionsl surgery BMI should be more than 30. You need to maintain any exercise instead

Pablo Garcia, MD - Account Suspended · Answer

Hello, I hope you are well. Your BMI is too low to consider bariatric surgery. I imagine your surgeon only removed 60% of your stomach precisely for this reason. a BMI of 25 is right at the limit in between normal weight and overweight. My recommendation is to follow up with a nutritionist so you are able to learn about healthy eating and exercise habits.

Gastric re-sleeve suitability - Can I expect 100% ghrelin removal and 80-90% stomach removal?

Answers (5)

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