Revision weight loss surgery
Encyclopedia
Revision Weight Loss Surgery is a surgical procedure that is performed on patients who have already undergone a form of bariatric surgery
Bariatric surgery
Bariatric surgery includes a variety of procedures performed on people who are obese. Weight loss is achieved by reducing the size of the stomach with an implanted medical device or through removal of a portion of the stomach or by resecting and re-routing the small intestines...

, and have either had complications from such surgery or have not successfully achieved significant weight loss
Weight loss
Weight loss, in the context of medicine, health or physical fitness, is a reduction of the total body mass, due to a mean loss of fluid, body fat or adipose tissue and/or lean mass, namely bone mineral deposits, muscle, tendon and other connective tissue...

 results from the initial surgery. Procedures are usually performed laparoscopically
Laparoscopic surgery
Laparoscopic surgery, also called minimally invasive surgery , bandaid surgery, or keyhole surgery, is a modern surgical technique in which operations in the abdomen are performed through small incisions as opposed to the larger incisions needed in laparotomy.Keyhole surgery makes use of images...

, though open surgery may be required if prior bariatric surgery has resulted in extensive scarring.

With the increase in the number of weight loss surgeries performed every year, there are growing numbers of individuals who have experienced an unsatisfactory result from their bariatric procedures. There are several weight loss surgery
Bariatric surgery
Bariatric surgery includes a variety of procedures performed on people who are obese. Weight loss is achieved by reducing the size of the stomach with an implanted medical device or through removal of a portion of the stomach or by resecting and re-routing the small intestines...

 options, some of which may limit later options for revision weight loss surgery.

Procedures

  • An adjustable gastric band
    Adjustable gastric band
    A laparoscopic adjustable gastric band, commonly referred to as a lap band, is an inflatable silicone device that is placed around the top portion of the stomach, via laparoscopic surgery, in order to treat obesity...

    is an inflatable silicone prosthetic device that is placed around the top portion of the stomach. This procedure can be performed as a revision procedure for many patients who have had a previous stomach stapling, gastroplasty procedure, or roux-en-Y gastric bypass surgery but have regained weight. The procedure is normally performed laparoscopically, though in a small minority of instances prior surgery may have resulted in extensive scarring, requiring open surgery.

  • Roux-en-Y gastric bypass is a commonly chosen revision technique, particularly in patients who have not been successful in meeting their weight loss goals after stomach stapling, gastroplasty, vertical gastric banding, or laparoscopic-adjustable gastric banding. Often the prior procedure still lends itself to a revision to become a roux-en-Y gastric bypass. It may be performed laparoscopically, and the average recovery time is approximately two weeks. The weight loss success rate after roux-en-Y gastric bypass revision surgery is generally excellent. There are some associated risks of Vitamin deficiency and stomach ulcer formation requiring prevention with multivitamins.

  • Sleeve gastrectomy
    Sleeve gastrectomy
    Sleeve gastrectomy is a surgical weight-loss procedure in which the stomach is reduced to about 25% of its original size, by surgical removal of a large portion of the stomach, following the major curve. The open edges are then attached together to form a sleeve or tube with a banana shape. The...

    removes a large portion of the stomach, with the remaining portion reshaped to become tube-like or sleeve-shaped. This creates an increased sense of satiety and decreased hunger in patients, often leading to weight loss and improved health. The procedure is generally less invasive than many other weight loss surgeries and has a lower potential for complications than may be associated with gastric bypass surgery
    Gastric bypass surgery
    Gastric bypass procedures are any of a group of similar operations that first divides the stomach into a small upper pouch and a much larger lower "remnant" pouch and then re-arranges the small intestine to allow both pouches to stay connected to it. Surgeons have developed several different ways...

    .

  • StomaphyX
    StomaphyX
    "The StomaphyX device is an endoluminal fastener and delivery system that consists of an ergonomic, flexible fastener delivery device and polypropylene fastener implants. All devices are packaged sterile, and are for single patient use."...

    revision is a completely endoscopic revision technique used to tighten a stretched gastric pouch using internal sutures or fasteners. It may be used in patients who have had prior roux-en-Y gastric bypass surgery and have a stretched stomach pouch.
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