Gastric Sleeve Revisions
The gastric sleeve or sleeve gastrectomy has quickly become the most popular weight loss surgery in the United States (as of 2013 ASMBS statistics). It is not only a straightforward procedure but an exceptionally effective one. However, much like any medical treatment, there is the potential for the procedure not to offer the expected degree of weight loss the patient or their surgeon expects.
Why The Gastric Sleeve Fails
Patients who consume too much food too quickly may get feedback from their band (in the form of discomfort or vomiting) or bypass (in the form of dumping syndrome – what is dumping syndrome?), but not often from their sleeve. As such, if patients aren’t tracking their food intake, they may not know they are overeating. For that reason and others, the most common cause of a failure in the gastric sleeve procedure usually revolves around the patient’s lifestyle. A lack of proper diet and consistent exercise is often the culprit of poor weight loss or weight regain.
If not caught soon enough, there is a chance that the sleeve shaped gastric pouch will begin to expand and enlarge. This allows patients to eat more at every sitting and, in turn, gain weight. The longer this goes untreated, the more weight a patient may regain.
Rarely, a gastric sleeve may fail to offer adequate weight loss because not enough of the stomach was removed during the first surgery.
Gastric Sleeve Revision Options
The safest and most effective way to combat weight regain is by recommitting to the prescribed post-surgical diet and exercise plan. However, if the gastric sleeve is sufficiently stretched, this may no longer be a viable option.
Since procedure-related weight regain almost always revolves around the stomach pouch stretching, surgical revisions are relatively straightforward. The sleeve can also be revised to a gastric bypass or a duodenal switch. This stepped approach to weight loss adds a malabsorptive component that can offer a second pathway to weight loss. This course of action would be considered a last resort as both the bypass and duodenal switch have added dietary restrictions and are more complex.
The gastric sleeve can be revised by performing a second sleeve procedure to re-shrink the gastric pouch and remove excess volume. This is called a re-sleeve and is performed in much the same way as the first procedure.
As with any revision, it is important that we fully evaluate each possibility. Revisional surgery comes with additional risk and should not be taken lightly. As such, a consultation with one of our bariatric surgeons is the best way to understand whether a revision is the right option.