What is Revisional Surgery?
Revisional bariatric surgery, typically applies to planned reoperations for either inadequate weight loss, or for problems inherent to the original surgery which did not manifest early on. Having another operation to address something related to an original bariatric procedure is probably not high on any patient’s postoperative expectations list.
These procedures are best carried out by more experienced bariatric surgeons at facilities that can provide the necessary support, like those we feature here at University Bariatrics. The high level of skill necessary to perform these operations makes experience and a proven track-record of excellence a must.
For revisional bariatric surgery in Thousand Oaks, Simi Valley, Moor Park, Newbury Park, Westlake Village, Agoura Hills, Camarillo, Conejo Valley, Ventura County and Oxnard, University Bariatrics has the state-of-the-art resources and talent needed to provide you with the care you deserve.
Types of Revisional Surgery Offered by University Bariatrics:
- Lap-Band or Realize Band Removal
- Vertical Banded Gastroplasty Reversal
- Conversion to Gastric Bypass
- Vertical Sleeve Gastrectomy Revision
- Re-sleeve gastrectomy
- Conversion to Gastric Bypass
- Gastric Bypass Reversal
For more information, and to find out if revisional weight loss surgery is right for you, contact us today at: (805) 379-9796.
Goals/Motivation for General Revisional Surgery:
Multiple procedures have been introduced by the industry to address ongoing and lingering issues after surgery. Their common goal is to provide additional restriction by adding foreign bodies, tightening, or even re-stapling/trimming of gastric pouches and surgical anastomoses. Although the stretching of surgical areas is a natural and well-described phenomenon, the extent of influence on recidivism is debated.
Revisional intervention can include placement of rings or even Lap Bands around them. Endoscopic suturing of pouches and surgical hookups can be performed as well. Whereas their short-term results have held promise, most have been ineffective in the longer run. Foreign bodies left behind as part of these procedures, furthermore, will impede safe application of surgical staplers during their ultimate conversion to gastric bypasses and duodenal switches.
The University Bariatrics team believes that by playing on patients’ hopes and fears, some programs tend to overstate potential benefits without giving much detail on side effects and alternatives. The resolution and improvement of medical comorbidities are the primary objectives of the bariatric surgery we perform, and not an idealized final weight. Focusing on the latter, furthermore, can lead to the very same issues and coping mechanisms that resulted in morbid obesity in the first place. Inadequate weight loss and significant weight regain are multifactorial issues that often do not lend themselves to just adding more surgery. It requires a more fundamental approach to the whole patient, which our multidisciplinary group is able to offer.
Reasons for Revisional Surgery:
- Weight Concerns After Surgery
- Nonresolution of obesity related comorbidities such as diabetes
- Lap-Band Explantation due to:
- Foreign body reaction
- General intolerance
- Inadequate weight loss
- Surgical Side-Effects
Procedure-Specific Revisional Surgery Information:
Lap Band Removal
Laparoscopic removal of Lap-Bands is offered through University Bariatrics. Should the overseas experience hold true in the U.S., the number of these cases is expected to rise dramatically in the near future. Not accounting for the more common problems such as slippage and port/tubing malfunction, other factors lead to Lap Band explantation as well. They include erosion, mega-esophagus, foreign body reaction, general intolerance, and inadequate weight loss among others. Our highly trained surgeons at University Bariatrics perform adjustable band removal for Thousand Oaks, Simi Valley, Moor Park, Newbury Park, Westlake Village, Agoura Hills, Camarillo, Conejo Valley, Ventura County and Oxnard area residents who require further assistance.
Steps for Lap-Band Removal
Lap Band removal can be performed as a single stage procedure concomitant with another weight loss operation. Alternatively, a two stage approach may be undertaken that allows for local tissue healing and after ensuring full resolution of band related symptoms or complications prior to adding yet another bariatric procedure.
Eroded Lap Band explantation, however, carries a much higher risk profile and in our opinion, should only be done as a stand-alone operation. The University Bariatrics team has extensive experience with these operations and was the first to report & publish the laparoscopic transgastric technique for the removal of eroded bands. We therefore look forward to the opportunity to discuss all of your band removal options with you so that you can decide on the best course of action for yourself!
Vertical Banded Gastrectomy Revisional Surgery:
The vertical banded gastroplasty was a popular operation in the 1980’s and early 90’s. The stomach was partitioned but not fully divided into two segments. The smaller portion was further restricted by placement of a band at its end to obstruct oral intake and cause early satiety. Intestinal rerouting was not utilized. Gradually, VBG was abandoned in favor of the gastric bypass procedure, in part due to complications related to the band or the staple line. The University Bariatrics team has performed several laparoscopic revisional surgeries including full reversal or conversion to the gastric bypass.
Vertical Sleeve Gastrectomy Revisional Surgery:
Laparoscopic conversion of sleeve gastrectomy to gastric bypass is typically carried out for technical complications seen in poorly performed sleeves, incomplete resolution of comorbidities, or side effects such as reflux unresponsive to medical therapy. Typical revisions include resleeve gastrectomy or conversion to a Roux En-Y gastric bypass.
Roux-En-Y Gastric Bypass Revisional Surgery:
Complete reversal of the RYGB is rarely performed but may be necessary in cases of medical or surgical side effects refractory to conservative therapy. The University Bariatric team has successfully performed these cases laparoscopically with no complications or the need for open conversion. The “Roux-En-Y Gastric Bypass” can also be converted successfully to the duodenal switch under certain circumstances and we can refer you to programs that have extensive experience in performing them.
In addition to removal of previous Lap Bands or other revisional bariatric surgery procedures, University Bariatrics surgeons can also perform a range of primary weight loss & general surgery procedures for Thousand Oaks, Simi Valley, Moor Park, Newbury Park, Westlake Village, Agoura Hills, Camarillo, Conejo Valley, Ventura County and Oxnard area residents.
For more information, and to find out if weight loss surgery is right for you, contact us today at: (805) 379-9796.
Revisional Surgery Frequently Asked Questions
When do I consider revisional surgery?
There are many reasons why one may qualify for revisional bariatric surgery at University Bariatrics. The most common reasons why our patients undergo revisional bariatric surgery are as follows: continued weight concerns after the original surgery, stretching of surgical areas, Lap-Band explantation for any reason, or any other negative unplanned surgical side-effects. If you are suffering from any of the above conditions or have any other concerns which you believe may qualify you for revisional surgery contact us today and schedule a consultation!
Will you do my revision if another surgeon performed the original surgery?
Yes! The location of your original surgery has no effect on qualifying for revisional surgery with University Bariatrics! Our highly-skilled surgeons are the best in the area at performing revisional surgeries to correct any bariatric issue where the original surgery may have lapsed or failed.
What are the results I can expect to see from a revisional surgery?
The resolution and improvement of medical comorbidities are the primary objectives of the bariatric surgery we perform, and not an idealized final weight. However, this does not mean that losing the weight is not a focus. Our revisional bariatric surgery is aimed at both reducing the impact of comorbidities as well as helping you to fix the issues with your original surgery. The end goal of our revisional surgery is for the resolution of the issues caused by the original surgery or reducing comorbidities, which may ultimately result in a significant amount of weight being lost!
What can I expect the day of my revisional surgery?
Depending on the procedure, the “day of” surgery expectations may vary. However, a standard experience at University Bariatrics has the patient resting in our recovery room after the procedure until the patient feels able to return to their home, the same day as the surgery or a few days later. Our experienced surgical and support teams are able to execute these procedures quickly and with the high level of performance you expect from University Bariatrics
Are there dietary expectations following my revisional surgery?
This is dependent upon the specific type of revisional surgery as well. However, as an overarching generalization, we suggest following a healthy lifestyle including exercise and a healthy diet as part of your recovery program.
Can I get pregnant after my revisional surgery?
Yes! Often times our patients whom have suffered through infertility as a comorbidity of their obesity are much more likely to be able to become pregnant after losing the weight. If this is a concern for you or a particular focus for your revisional surgery call our office today at (805) 379-9796 and speak with our team today!
Will revisional surgery cure my diabetes?
We cannot guarantee that any revisional procedure will “cure” or completely alleviate any comorbidities of obesity which a patient suffers from. However, it has been scientifically proven in many medical studies and medical journeys that bariatric surgery and weight loss have positive effects upon many comorbidities of obesity, including type 2 diabetes. To find out more information about the probability of seeing a reduction in your comorbidities call our office and speak with a member of our team today!
Is revisional surgery a painful procedure?
All of our revisional surgeries are performed in a minimally-invasive “keyhole” style. While the patient may experience mild pain or discomfort from the actual surgery, if you experience significant pain or discomfort following your revisional bariatric surgery, please contact our office immediately and speak with your surgeon!