Gastric Bypass Revisions In New Jersey
While the gastric bypass is meant to be a permanent procedure, there is the possibility that it will need to be revised over the course of time. With that said, most gastric bypass patients will regain about 5-10% of their excess body weight after reaching their target weight. This is normal. More concerning is when a patient’s weight begins to fluctuate more dramatically or when they begin to regain a significant amount of weight. At this point, it is important that the patient schedule a consultation with their surgeon to begin the process of finding a solution.
Why The Bypass Fails
By far the most common cause of weight regain is poor diet and exercise. Remember, the bypass only provides assistance with weight loss – it is ultimately up to the patient to keep their weight off over the longer-term. Some patients may find it more difficult to follow their prescribed diet several years down the road. What they think are small indulgences and cheats, can eventually lead them off-track.
If diet and exercise is not to blame, we begin to look at the main culprits of gastric bypass failure – stretching. First is the stomach…an amazingly versatile organ. The gastric pouch can begin stretch over time, especially if the patient is not following their diet closely. This stretching is gradual but can cause significant weight regain over time.
The stomal opening (that regulates the passage of food between the stomach and the small intestine) can also begin to dilate and allow food to pass through more readily. This is common in a gastric bypass since the stoma is recreated by the surgeon during the procedure.
What Can Be Done To Revise A Gastric Bypass?
There are several options for gastric bypass patients including:
Endoscopic procedures to reduce the size of the stomach pouch or the stoma. These procedures are relatively effective in the short-term, have little risk and many can be performed on an outpatient basis. Studies on their effectiveness over the longer-term have shown mixed results.
Adding a gastric band to the top of the gastric pouch. The band provides additional restriction. However, it also creates the risk of band-related complications on top of the considerations of the bypass itself.
Converting the gastric bypass to a Duodenal Switch (DS) can be useful for some patients. While this is a relatively complex procedure, it has shown promise in the few studies conducted. It is important to note that the DS is considered largely experimental and few insurance plans cover it.
Ultimately, it is important to remember that a revisional bariatric procedure comes with greater risk than the original surgery. As a result, concerted lifestyle re-evaluation and modification will always be our first step. If, in fact, a patient does need an additional procedure to correct poor weight loss or significant weight regain, they will have the opportunity to discuss their options at a consultation with one of our surgeons.