Is it possible to have a sleeve reversed? (Photo)

Question

I had my gastric sleeve surgery last April I lost my weight too fast I have lost almost a hundred and thirty pounds in a year. I have been sick and I am hardly able to keep things down. how can I have my surgery reversed? I can't keep anything down I have been hospitalized twice and I stay severely dehydrated I'm wishing I never had it done

Wiljon W. Beltre, MD · Answer

I am sorry you had such a bad experience with the sleeve.  The gastric sleeve is a procedure well tolerated by most patients.  However, some times issues do come up that may need surgical treatment.  To answer your question, no the gastric sleeve can not be reversed. However, any issues with the sleeve can be treated some times with a second procedure.  These are the things that come to mind when I look at your symptoms: you may have a stricture or narrowing, you may have a twist in the sleeve that tend to cause nausea, do you still have your gall bladder as these may be gall bladder symptoms.  you may also have severe GERD or acid reflux this may some times present with nausea and vomiting.  You need to have an endoscopy and an upper gi series.  Depending on the results you may need to have the sleeve revised to the gastric bypass.  Don't worry, you will not lose more weight as a result of revising the sleeve to the gastric bypass.  your symptoms will go away and you will be able to eat again.  I do these revisions all the time for similar symptoms.  Consult with an experienced bariatric surgeon in your area.

Ali Solmaz, MD · Answer

I’m really sorry you're going through this. Losing 130 pounds in a year is a very rapid weight loss, and the fact that you're struggling to keep food down and dealing with severe dehydration is extremely concerning. Since you've already been hospitalized twice, you need to see a bariatric specialist urgently to figure out what’s going on.
There are several possible reasons for your symptoms. One common issue is a stricture, where the stomach opening becomes too narrow, preventing food and liquid from passing through properly. This can often be treated with an endoscopic dilation procedure. Another possibility is severe acid reflux or gastroparesis, where the stomach empties too slowly, leading to constant nausea and vomiting. Some medications, such as proton pump inhibitors or motility agents like Reglan, may help if this is the case. Malnutrition is another concern, especially with rapid weight loss. Deficiencies in vitamins like B1 (Thiamine), B12, and Iron can cause severe weakness, nausea, and other complications. Bloodwork can help determine if this is a factor.
Reversing a gastric sleeve isn’t commonly done, but if your sleeve is too tight or has caused severe complications, some surgeons may consider converting it to a gastric bypass or duodenal switch. In some cases, a partial revision can help make the stomach less restrictive. The most important step right now is to get a thorough evaluation. An endoscopy can check for strictures, ulcers, or other abnormalities, and bloodwork can help assess nutritional deficiencies.
While you wait to see a specialist, try to stay hydrated with small sips of electrolyte solutions like Pedialyte, coconut water, or bone broth. If you can’t keep anything down, you may need IV fluids again. A nutritionist may also help you find foods that are easier to tolerate.

Shawn Garber, MD, FACS, FASMBS · Answer

If you are having issues keeping food down you should seek the advice of your bariatric surgeon or a second opinion from another bariatric surgeon as soon as possible.  There is no way to reverse a sleeve gastrectomy because the large portion of the stomach was removed.  If you have a stricture or a twist it can sometimes be fixed with endoscopy and a stent or sometimes requires conversion to a sleeve gastrectomy.  It is important for you to seek the advice of a qualified bariatric surgeon to get to find out why you are having problems right away.

Hossein Bagshahi, MD, FACS, FASMBS · Answer

Since the lateral portion of the stomach is removed during sleeve gastrecotmy it can not be reversed. However, depending on what your exact symptoms are and what your eating pattern is there are options. 
Best thing to do is visit with your surgeon, keep a food journal and visit with the dietician. your surgeon will discuss your issues and review your symptoms, and go from there. 
Options for work up are: barium swallow with upper GI   (x-ray test) and/or endoscopy to look at the esophagus, and stomach itself to gain a better understanding of the anatomy.
If you are not able to eat well because of the reflux, or kink, or unacceptable angulation, the option of revision to RNY gastrojejunostomy with address these issues. 
The key is make sure you are doing your part  in regard to "pouch rules," eating patterns, etc (that is the point of keeping the food journal and visiting with the surgeon and dietician first).

Pablo Garcia, MD - Account Suspended · Answer

Hello, I am very sorry to hear you are having these health issues following your sleeve and hope you are doing better. It is not possible to reverse a gastric sleeve, as we are talking about removing a portion of your stomach. It cannot be reattached. It is common for bariatric patients to get dehydrated, which is why it is so important to receive proper education about your daily water intake. This should be an issue you should be able to resolve with the help of your bariatric team. On the other hand, if you are having ongoing problems with nausea and vomiting, it may be beneficial to get some imaging studying to confirm the integrity and correct placement of your sleeve. I hope this answer was useful.

Is it possible to have a sleeve reversed? (Photo)

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