Revision Weight Loss Surgery
Heartburn – Reflux – hiatal Hernia after weight loss surgery
One of the most common complaints that leads to revision weight loss surgery is heartburn or reflux. Often the symptoms experienced by the patients are caused by other reasons than acid alone
The heartburn - reflux like symptoms can be caused by:
Acid reflux
Herniation of the sleeve or bypass pouch into the chest in such a manner that it is now causing a partial obstruction to the passage of food
Bile refluxing up into the stomach and esophagus
Stricture / Obstruction formation
Torsion (twisting of the sleeve)
Next steps / Options
When experiencing the symptoms or complications described above get help. Find a bariatric surgeon (weight loss surgeon) as soon as possible who does revision surgery. The symptoms will usually continue to get worse not better.
The best studies to diagnose the problem is an UGI (upper gastric swallowing study) and an Upper Endoscopy (scoping of your stomach) to evaluate the function of your weight loss operation and determine what has changed about your weight loss operation since your surgery.
After the UGI and Upper Endoscopy it should become apparent what is causing the problem(s) you are experiencing, and the surgeon will start discussing with you what can and cannot be done to correct or improve the problem.
Your options may include:
Changing your medication regimen
Staring a new medication
Stretching of a stricture
Reversing the weight loss operation
Revision of an anastomosis
• Reducing pouch size / Anastomosis size
Converting the weight loss operation to another weight loss operation
Undergoing a Hiatal Hernia reduction and repair of the trapped stomach in the chest
One of the most common complaints that lead to revision weight loss surgery is heartburn or reflux. Often the symptoms experienced by the patients are caused by other reasons than acid alone.
The heartburn - reflux like symptoms can be caused by:
Acid reflux
Herniation of the sleeve or bypass pouch into the chest in such a manner that it is now causing a partial obstruction to the passage of food
Bile refluxing up into the stomach and esophagus
Stricture
Lap-Band Revisions
Though the Lap-Band used for weight loss in individuals who have failed to lose weight through diet and exercise, many patients can experience sub-optimal weight loss despite the surgery, or develop complications. In such cases, revision weight loss surgery may be needed to induce or maintain weight loss or correct a complication.
If you are experiencing:
difficulty swallowing that is causing you to cough/choke/throw up when you eat, lie down or sleep
food getting stuck repeatedly
Eating mostly a liquid, saucy, crunchy and flaky food diet and avoiding the more solid, dry, dense or doughy foods
Having progressive trouble with heartburn / reflux that is not responding to medication anymore
You may have one of these complications:
· Lap-Band intolerance (inability to eat solid food)
Esophageal dilatation (stretching of the swallowing pipe)
Obstruction of the Lap-band (band too tight, band too high, band slippage – too much stomach above the band)
Lap-band slippage (pouch has become large and intermittently is causing obstruction)
Lap-Band erosion (band rubs into the stomach)
Next steps / Options
When experiencing the symptoms or complications described above get help. Find a bariatric surgeon (weight loss surgeon) as soon as possible who does revision surgery. The symptoms will usually continue to get worse not better.
The best studies to diagnose the problem is an UGI (upper gastric swallowing study) and an Upper Endoscopy (scoping of your stomach) done by a bariatric surgeon to evaluate the function of your band and determine what has changed about your lap-band, stomach and esophagus since lap-band surgery.
After the UGI and Upper Endoscopy it should become apparent what is causing the problem(s) you are experiencing, and the surgeon will start discussing with you what can and cannot be done to correct or improve the problem.
Your options may include:
Inflating / Deflating the lap-Band
Removing the Lap-Band
Converting the Lap-band to a Sleeve gastrectomy
Converting the Lap-Band to a Gastric Bypass
Undergoing a Hiatal Hernia reduction and repair with/without an anti-reflux procedure
Gastric Sleeve Revisions
The Sleeve Gastrectomy operation is used in morbidly obese patients to lose weight. Some patients can experience sub-optimal weight loss despite the surgery, or develop complications. In such cases, revision weight loss surgery may be needed to induce or maintain weight loss or correct a complication.
If you are experiencing:
heartburn / reflux that is getting progressively worse and medication is not controlling it
difficulty swallowing that is causing you to choke/throw up when you eat, lie down or sleep
Chest pain after eating
Eating mostly a liquid, soft, saucy, crunchy and flaky food diet and are avoiding the more solid, dry, dense or doughy foods
Significantly lower weight loss than predicted
Significantly higher weight loss than predicted
You may have one of these complications:
Heartburn / reflux / Hiatal hernia
Incarcerated / Herniated sleeve (sleeve trapped/herniated into the chest)
Stricture / torsion of sleeve (narrowed or twisted causing obstructive problems)
Biliary reflux/gastritis/esophagitis (bile causing irritation of stomach and esophagus)
Large Sleeve
Incomplete Sleeve
Next steps / Options
When experiencing the symptoms or complications described above get help. Find a bariatric surgeon (weight loss surgeon) as soon as possible who does revision surgery. The symptoms will usually continue to get worse not better.
The best studies to diagnose the problem is an UGI (upper gastric swallowing study) and an Upper Endoscopy (scoping of your stomach) to evaluate the function of your sleeve and determine what has changed about your sleeve since your surgery.
After the UGI and Upper Endoscopy it should become apparent what is causing the problem(s) you are experiencing, and the surgeon will start discussing with you what can and can not be done to correct or improve the problem.
Your options may include:
Changing your medication regimen
· Staring a new medication
· Endoscopic Stent placement
· Re-sleeving the sleeve
· Converting the Sleeve to a Gastric to Bypass
· Undergoing a Hiatal Hernia reduction and repair of the trapped sleeve in the chest
Gastric Bypass Revisions
The Gastric Bypass operation is used in morbidly obese patients to lose weight. Some patients can experience sub-optimal weight loss despite the surgery, or develop complications. In such cases, revision weight loss surgery may be needed to induce or maintain weight loss or correct a complication.
If you are experiencing:
heartburn / reflux that is getting progressively worse and medication is not controlling it
difficulty swallowing that is causing you to choke/throw up when you eat, lie down or sleep
Eating mostly a liquid, saucy, crunchy and flaky diet and can-not eat the more solid, dry, dense or doughy foods
Epigastric abdominal pain (area between the chest and abdomen)
Significantly lower weight loss than predicted
Significantly higher weight loss than predicted
You may have one of these complications:
Marginal ulcer
Stricture, Stricture with high grade obstruction
Gastro - Gastric Fistula
eartburn / reflux
Incarcerated / Herniated pouch (more common if patient was converted from sleeve to bypass – pouch is trapped/herniated in the chest)
Biliary reflux/gastritis/esophagitis (bile causing irritation of stomach and esophagus)
Large gastric pouch / horizontal gastric pouch
Next steps / Options
When experiencing the symptoms or complications described above get help. Find a bariatric surgeon (weight loss surgeon) as soon as possible who does revision surgery. The symptoms will usually continue to get worse not better.
The best studies to diagnose the problem is an UGI (upper gastric swallowing study) and an Upper Endoscopy (scoping of your stomach) to evaluate the function of your bypass and determine what has changed about your bypass since your surgery.
After the UGI and Upper Endoscopy it should become apparent what is causing the problem(s) you are experiencing, and the surgeon will start discussing with you what can and can not be done to correct or improve the problem.
Your options may include:
• Changing your medication regimen
• Staring a new medication
• Stretching of the gastro-jejunostomy (stricture)
• Reversing the bypass operation
• Revision of the gastro-jejunostomy (pouch outlet)
• Reducing pouch size / Anastomosis size
• Converting the Sleeve to a Gastric Bypass
• Undergoing a Hiatal Hernia reduction and repair of the trapped pouch in the chest