Revision Weight Loss Surgery

As more and more weight loss surgery is being performed revision or reoperation surgery is going to play a more important role in weight loss surgery.  While weight loss surgery is currently the most effective method for sustained long-term weight loss and resolution of many co-morbidities (medical problems) there will be patients with a partial or no-response, and who will develop complications.

At times even a successful operation may not be enough to reduce the patients weight into an adequately low range to improve or resolve their medical problems.  It is also important to remember that morbid obesity is a chronic disease, and its surgical treatment may also be chronic.

Revision surgery is either the modification, repair or correction of a weight loss operation or the conversion of one weight loss operation to another, and rarely a reversal of the operation.

Revision surgery may need to be performed for many reasons:

-        Sub-optimal weigh loss

-        Excessive weight loss

-        Persistent medical problems

-        Early complication(s)

-        Late complication(s)

Revision surgery types include:

-        Corrective treatment for an early or late complication

-        Reversal of a weight loss operation

-        Conversion from one to another weight loss operation

Revision surgery carries more risk than primary weight loss surgery, and should be performed by more experienced laparoscopic bariatric surgeons in MBSAQIP bariatric surgery centers.

CONVERSION SURGERY

The most common weight loss operations undergoing conversion are the Lap-Band and Sleeve gastrectomy operations.  The lap-Band is most often converted to a sleeve gastrectomy, and the sleeve gastrectomy to the gastric bypass weight loss operation.   The most common reason why these conversions occur are heartburn-reflux and suboptimal weight loss.  The Converted weight loss operations have very similar weight loss as their primary counterparts.

REVERSAL SURGERY

The most common weight loss operation undergoing reversal is the lap-band, and less often the gastric bypass.   The lap-band can simply be reversed by removing the band and port, the gastric bypass is a more complicated and riskier operation.  The most common reason for reversal is a complication that is not responding to medical treatment.

CORRECTIVE TREATMENT

All weight loss operations can undergo corrective revision surgery.  The most common indication will be early or late complications of weight loss surgery.