I lost 100 pounds from sleeve and did well for 8 years but now I am 70 pounds overweight and want to have another sleeve done . any added risks because it's the second time? will surgery still work for me even if it's not 100 percent as effective as the first time?
Answer: Expert revision surgery does help... For starters, the cause of failure has to be assessed. In our experience many sleeves that are associated to weight gain are usually dilated or stretched. When an initial procedure is submitted to the pressure of food over time it can potentially stretch in certain circumstances. Contrary to popular belief bougie size does matter. Too tight and food will back up. Too lose and you might end up with a stretched pouch over time. It is explained by Pascal's principle and the Law of LaPlace. So, to answer your question, after a barium swallow we typically find an enlarged pouch and an associated increase in the amount of food a patient can eat. In certain cases reducing the size of the pouch reduces food intake and promotes weight loss. In our hands we have revised many sleeves by reestablishing appropriate dimensions and the desired weight loss. I personally hate to convert a sleeve that had been successful in the past to another procedure (with its own set of associated risks) when I can simply fix what went wrong with the original procedure. Following guidelines mentioned by Dr Simpson y a must as well.
Helpful 3 people found this helpful
Answer: Expert revision surgery does help... For starters, the cause of failure has to be assessed. In our experience many sleeves that are associated to weight gain are usually dilated or stretched. When an initial procedure is submitted to the pressure of food over time it can potentially stretch in certain circumstances. Contrary to popular belief bougie size does matter. Too tight and food will back up. Too lose and you might end up with a stretched pouch over time. It is explained by Pascal's principle and the Law of LaPlace. So, to answer your question, after a barium swallow we typically find an enlarged pouch and an associated increase in the amount of food a patient can eat. In certain cases reducing the size of the pouch reduces food intake and promotes weight loss. In our hands we have revised many sleeves by reestablishing appropriate dimensions and the desired weight loss. I personally hate to convert a sleeve that had been successful in the past to another procedure (with its own set of associated risks) when I can simply fix what went wrong with the original procedure. Following guidelines mentioned by Dr Simpson y a must as well.
Helpful 3 people found this helpful
Answer: A second time intervention it is not uncommon to see patients who need a second intervention due to multifactorial weight regain. A second intervention would have the same risks as the first one, taking into account the underlying medical pathologies that the patient may have. In these cases we could talk about conversion surgery (either converting the previous sleeve to a Bypass or another procedure). In case of a second intervention, although not in the same way as the first one, an optimal weight loss could be achieved, going hand in hand with your surgeon and the nutritionist who will be giving you postoperative follow-up. It is also important to identify what habits of the routine could induce a weight regain and change them for a healthier lifestyle.
Helpful
Answer: A second time intervention it is not uncommon to see patients who need a second intervention due to multifactorial weight regain. A second intervention would have the same risks as the first one, taking into account the underlying medical pathologies that the patient may have. In these cases we could talk about conversion surgery (either converting the previous sleeve to a Bypass or another procedure). In case of a second intervention, although not in the same way as the first one, an optimal weight loss could be achieved, going hand in hand with your surgeon and the nutritionist who will be giving you postoperative follow-up. It is also important to identify what habits of the routine could induce a weight regain and change them for a healthier lifestyle.
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March 20, 2017
Answer: Re-Sleeve There is definitely added risks because it's the second time! You have higher chance of major complications like Staple Line Leak. In my practice we offer the Re-Sleeve, even though it is not as effective as first time. You need to modify your eating habit and activity regardless, but I believe that a revision to Gastric Bypass would be more beneficial and safer in this situation...
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March 20, 2017
Answer: Re-Sleeve There is definitely added risks because it's the second time! You have higher chance of major complications like Staple Line Leak. In my practice we offer the Re-Sleeve, even though it is not as effective as first time. You need to modify your eating habit and activity regardless, but I believe that a revision to Gastric Bypass would be more beneficial and safer in this situation...
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February 20, 2017
Answer: Re sleeve in my optinion a resleeve is not a good option. the best weight loss operation for you at this point would be a revision to duodenal switch or SIPS (modified DS) depending on your current bmi. these operations are performed laparoscopically like the sleeve but they cause weight loss by limiting your bodies ability to absorb fat calories. for whatever reason restrictive operations tend to have a shelf life for some patients as evidenced by the large number of patients who have weight regain after gastric bypass (which is mostly a restrictive operation as well). a re sleeve is technically easier to do, but not without higher risk and the likelyhood of success is not high enough to justify the risk in my opinion. Im one of few surgeons that offers these surgical options so you may find it hard to locate a surgeon in your area that does. As sleeve has been done in very high volume for the last 7 years or so there is going to be many patients like you who did well but unfortunately the effects of the sleeve didnt provide durable weight loss.
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February 20, 2017
Answer: Re sleeve in my optinion a resleeve is not a good option. the best weight loss operation for you at this point would be a revision to duodenal switch or SIPS (modified DS) depending on your current bmi. these operations are performed laparoscopically like the sleeve but they cause weight loss by limiting your bodies ability to absorb fat calories. for whatever reason restrictive operations tend to have a shelf life for some patients as evidenced by the large number of patients who have weight regain after gastric bypass (which is mostly a restrictive operation as well). a re sleeve is technically easier to do, but not without higher risk and the likelyhood of success is not high enough to justify the risk in my opinion. Im one of few surgeons that offers these surgical options so you may find it hard to locate a surgeon in your area that does. As sleeve has been done in very high volume for the last 7 years or so there is going to be many patients like you who did well but unfortunately the effects of the sleeve didnt provide durable weight loss.
Helpful
February 15, 2017
Answer: No Surgery is not "effective" it is what you do that makes things work. If you didn't change eating habits and have a diet that is calorie rich and processed then you will not be successful again. Redo surgery has six times the risk of the first surgery. Before you even consider I would highly suggest you examine your diet carefully and work to change it. Making fruits and vegetables the primary part of your diet, decreasing processed foods like pizza, burgers, chips, cookies - and learning how to eat healthy
Helpful
February 15, 2017
Answer: No Surgery is not "effective" it is what you do that makes things work. If you didn't change eating habits and have a diet that is calorie rich and processed then you will not be successful again. Redo surgery has six times the risk of the first surgery. Before you even consider I would highly suggest you examine your diet carefully and work to change it. Making fruits and vegetables the primary part of your diet, decreasing processed foods like pizza, burgers, chips, cookies - and learning how to eat healthy
Helpful