Types of revisional surgery
- Band over Bypass is the revision of gastric band surgery. An additional gastric band is placed over the small stomach pouch made in the first gastric bypass surgery.
- Gastric Band to Gastric Bypass, or Vertical Sleeve Gastrectomy, is the removal of the gastric band proceeding with gastric bypass or vertical sleeve gastrectomy.
- Gastric Sleeve to Biliopancreatic Diversion with Duodenal Switch (BPD-DS). The sleeve gastrectomy is the first step in a BPD-DS so the conversion follows naturally.
- Gastric Bypass to Gastric Sleeve to Biliopancreatic Diversion with Duodenal Switch.
- Gastric Bypass to Longer-Limb Gastric Bypass is a revision that further reduces nutrient absorption by bypassing a greater portion of the small intestine.
- BPD-DS to BPD-DS with smaller pouch size is a revision that further increases the restrictive effects of BPD-DS.
Is it right for me?
It is important to carefully consider the reasons why the first surgery did not lead to the desired weight loss. If the patient did not make the necessary lifestyle changes after the first surgery, it is unlikely that revisional surgery will be successful unless you follow the necessary dietary and lifestyle changes.
Other medical reasons for revisional surgery:
- Stomach pouch has dilated and needs to be restricted (made smaller) again.
- The gastric band can be replaced if it has slipped or there is leakage from the connection tube.
- Leak from seams after gastric bypass, BPD-DS or vertical sleeve gastrectomy.
What is the recovery like?
If you are having revisional surgery you can expect a longer recovery time than the first surgery. You can experience some stomach pain and may need pain relief for the first week or two after surgery. The surgical incision may be tender and sore to touch.
Depending on how the surgery was performed (open or laparoscopic) recovery will be a period of 4 to 6 weeks. Patients who have laparoscopic surgery will recover faster. For patients having open surgery it is especially important to avoid heavy lifting and strenuous exercise during the recovery period.
What are the risks and complications?
All revisional surgeries carry the same risks and complications as the first surgery. However, patients undergoing a revisional procedure are at a greater risk of complications occuring a second time around.
Please seek and follow the specific guidelines from your bariatric team. Guidelines vary for individual patient needs and surgeries.