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Initial evaluation of a failed bariatric operation requires a careful nutritional evaluation, psychiatric evaluation to make sure emotional, stress eating, is not the cause. Next an evaluation of the anatomy based on an upper GI looking at size of the sleeve, in addition a solid phase study looking at transit time of the food bolus. Based on this information there are several options available. None are as effective as initial surgery and all revision surgical option are at a higher risk profile for the patient than the original operation.Therefore, we are always cautious to proceed to surgical options when the initial surgery was ineffective. Depending on the cause of failure your doctor and you can decide what is the best choice. The following options can be considered depending on your doctors comfort with the procedure and your reason for not acheiving your weightloss goal. 1. Placement of a gastric band over your sleeve, 2. Plication of the sleeve, 3. Re-sleeving the sleeve, 4. conversion to a gastric bypass, 5. Conversion to Duodenal switch operation.
Evaluation of the initial sleeve gastrectomy is key with Upper GI (barium swallow test) to look at anatomy, upper endoscopy to look at size and other problems.Once evaluation has been completed and you've discussed what the issue is with the current sleeve (weight loss, trouble with food sticking, dumping, diarrhea or other) with a bariatric surgeon, then you can decide what solutions are best. The solution will greatly depend on what the problem is and the diagnostic results. Revision surgery carries different risks and benefits. Higher leak rates and other complications do exist depending on the solution you decide might work, so consultation with a bariatric surgeon experienced in revision sleeve gastrectomy or complex bariatrics is very important.Weight regain and dilated sleeve or sleeve that is to large can be resleeved or plicated, converted to gastric bypass or band over bypass, but also requires a discussion with nutritionist who specializes in bariatrics. Patients can regain all the weight the've lost if eating patterns and food choices are changed or guided with input from professionals in a bariatric programReflux or dysphagia (food sticking) requires potentially different solutions. Sometimes surgery is the answer, sometimes endoscopy sometimes just nutritional support and counseling.
Hi. When an sleeve gastrectomy has done we have to check why doesnt worked. It can be first that have to do changes in your habbits and quality of your meals. Second the sleeve can growth with time and rarerly by technical issues.you have to be study maybe with an upper endoscopy or gastrography to see how it looks.you have more options. 1. Revision and convert to a bypass 2. Plicate the sleeve and 3. Re sleeve.
My patients go home when they are tolerating a liquid diet, ambulating, pain is controlled, and I am not worried about a leak. Usually that happens the day after surgery. Some patients stay a bit longer because of nausea. I would never send a patient home the same day as...
The stomach walls are muscle, and they contract and expand as we eat, so the stretch a bit. Immediately after the surgery, the scaring process and swelling might make your new stomach a bit rigid, so as the healing process continue it will expand a little bit when you eat. That’s why we tell t...
Although it is possible to perform them during the same operative time, the weight loss resulting from the gastric sleeve would outweigh the results achieved with breast augmentation. Ideally, after the gastric sleeve is performed, once the ideal weight loss has been achieved, a year later, the...
