What is Revision Bariatric Surgery?
Revision bariatric (weight loss) surgery refers to a second surgery that is performed to modify or correct a previous bariatric procedure. It is typically considered for patients who have not achieved the desired weight loss results, have regained weight, or are experiencing complications or adverse effects from the initial surgery.
Within Australia and our practice, we are seeing a rise in rate of revision surgery. This is attributed to the maturity of bariatric surgery within Australia and in particular larger cities like Sydney, where the number of patients who have undergone primary weight loss surgery is increasing.
Common Reasons for Considering Revisional Surgery
- If you have had inadequate weight loss
- If you have had issues of significant weight regain
- Inadequate control of obesity-related illness after initial surgery
- Complications after weight loss surgery e.g. Reflux, stricture, ulcers or band intolerance
- Desire for a different procedure to control weight better
The decision to undergo revision surgery can be difficult to make on your own. At SGOS, we have had decades of experience and can work with you on whether undergoing revision surgery is beneficial to you.
What Revision Surgery Options Do You Have?
This does depend on your primary weight loss surgery
Here are the most common revision options:
Revison from Gastric Band
- Removal of Gastric Band and converting to Gastric Sleeve
- Removal of Gastric Band and converting to Gastric Bypass
For more information on band revision, please read: https://pubmed.ncbi.nlm.nih.gov/28569358/
Revision from Gastric Sleeve
- If the volume of your sleeve is on the larger side – There may be an option to consider Re-sleeve
- Conversion of Gastric Sleeve to Gastric Bypass
- If you suffer from significant reflux and have concurrent hiatal hernia – Repair of Hiatal Hernia or conversion to Gastric Bypass
- If you are experiencing issues with sleeve stricture – endoscopic dilitation options to correct points of excessive narrowing
For more information on re-sleeve and its utility – please read: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10720822/
for more information on sleeve to bypass – please read: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10531699/
Revision from Gastric Bypass
- If you are suffering from bile reflux symptoms – we can consider converting Mini Bypass (one anastomosis gastric bypass) to Roux – en Y Gastric Bypass
- Lengthening your Bypass to achieve better weight loss control
- Endoscopic options with Overstitich Device to narrow the existing Gastric pouch or reducing the gastric outlet to improve restriction
for more information on the Overstitch device and how it can help, please read: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10504039/
Preparing for Revision Bariatric Surgery
Corrective surgery is a big commitment not only from a financial sense but also from a health prospective. If you are ready to take the plunge, make sure that you are set up right so that we can maximise outcomes with revisional surgery.
- Set Realistic Expectations:
- Understand that revision surgery can be more complex and may have different outcomes compared to the initial surgery.
- Mental Preparedness:
- Focus on the reasons for the revision and maintain a positive mindset.
- Be prepared to engage in stress-reducing activities such as meditation or gentle exercise
- Medical History and Physical Examination:
- Provide a complete medical history, including details of your previous bariatric surgery and any complications.
- Undergo a thorough physical examination to assess your current health status.
- Nutritional Assessment:
- Meet with our dietitian to evaluate your current dietary habits and nutritional status.
- Correct any nutritional deficiencies before surgery.
- Psychological Evaluation:
- Consult with our psychologist is highly recommended to address any mental health concerns and ensure you are mentally prepared for another surgery.
Laboratory Tests, imaging and endoscopy:
- Complete necessary blood tests to check for deficiencies or other issues.
- You will need to undergo imaging studies like a CT Fizz study (assess your current stomach volume) and endoscopy, to evaluate the anatomy and function of your digestive system.
- Dietary Changes:
- Follow a preoperative diet as recommended by your surgeon or dietitian. This may include a liquid diet a few days before surgery to reduce liver size and decrease surgical risks.
- Medications:
- Discuss all medications and supplements with your surgeon. You may need to stop certain medications before surgery.
- Avoid non-steroidal anti-inflammatory drugs (NSAIDs) and blood thinners as directed.
- Lifestyle Modifications:
- Cease smoking at least a few weeks before surgery, as smoking can increase the risk of complications.
- Reduce or eliminate alcohol consumption.
- Weight Management:
- Aim to lose a small amount of weight before surgery to reduce surgical risks and improve recovery.
- Exercise:
- Engage in regular physical activity to improve overall health and fitness.
- Support System:
- Arrange for support from family or friends to help you during the recovery period.
- Consider joining a support group for bariatric patients.
- Fasting:
- Follow your surgeon’s instructions regarding fasting before surgery, usually nothing to eat or drink after midnight the night before.
- Personal Preparations:
- Pack a hospital bag with essentials such as comfortable clothing, toiletries, and any necessary medical devices.
- Arrange for transportation to and from the hospital.
- Recovery at Home:
- Prepare your home for your recovery period, including having easy-to-prepare healthy foods on hand.
- Set up a comfortable rest area with necessary supplies within reach.
- Follow-Up Care:
- Schedule follow-up appointments with your surgeon and dietitian.
- Adhere to post-operative dietary guidelines and gradually reintroduce solid foods as recommended.
Here at SGOS, we can not stress enough the importance of long term follow up. We need to recognise that obesity is a chronic condition and what ever the surgery – sleeve vs bypass is just the beginning of your journey. This is why we are different from most other practices and are committed in providing you with life-long weight loss follow up and support. Our patient Journey – https://stgeorgeobesitysurgery.com.au/patient-information/the-patient-journey/
- To achieve long term results – following up regularly at planned intervals
- 1st year – at least 4 reviews with your surgeon and dietitian
- 2nd year – at least 2 reviews with your surgeon and dietitian
- 3rd year onwards – at least 1 review with your surgeon and dietitian
What are the Risks and Outcomes?
Risks
- Revision surgeries are generally more complex and carry higher risks than the initial procedures due to scar tissue, altered anatomy, and previous surgical changes.
Outcomes
- Revision bariatric surgery can be effective in achieving additional weight loss and resolving complications, but outcomes can vary widely based on the patient’s health, the type of revision performed, and adherence to post-operative guidelines.
It’s essential to consult with our team who has experience in revision procedures to determine the best course of action for individual cases.
Why Choose Us for Revision Bariatric Surgery
High Volume Revision Bariatric Surgery Experience
At SGOS, we have helped thousands of patients in their weight loss journey. We are experienced in what we do and you can count on us getting you through surgery safely and achieving the best outcomes for you
Comprehensive Revision Options
Dr Cheng is an accredited Bariatric surgeon of excellence which means that he is not only well trained in all aspects of bariatric surgery but is also at the forefront of new techniques when it comes to weight loss management.
You can trust that we will be able to tailor management according to your situation so that you always get the RIGHT option for you
Long term Bariatric Care
Here at SGOS, we can not stress enough the importance of long term follow up. Obesity is a chronic condition and what ever the surgery – sleeve vs bypass is just the beginning of your journey. This is why we are different from most other practices and are committed in providing you with life-long weight loss follow up and support. This includes yearly bulked bill consults with Dr. Cheng and our dietitian beyond your two year intensive bariatric follow up.
Our patient Journey – https://stgeorgeobesitysurgery.com.au/patient-information/the-patient-journey/
One of the Most Affordable Revision Surgery Programs in Sydney
We understand the large financial implications of accessing surgery and bariatric care which is only made worse through testing times with the current economy. Just like you, we are frustrated that bariatric services are not more accessible through the medicare system.
This is why we are determined in providing you with the lowest cost in accessing bariatric care. You can find our Transparent Bariatric Program costs here – https://stgeorgeobesitysurgery.com.au/patient-information/cost/
