Revisional Bariatric Surgery

What is Revisional Bariatric Surgery?

Revisional bariatric surgery refers to any procedure undertaken to correct, adjust, or revise a previous bariatric surgery. It is often considered when initial weight loss goals have not been met; weight regain occurs, or complications arise following the primary bariatric surgery. The goal of revisional surgery is to help patients reach healthier body weight and improve or resolve related health issues.

For individuals who have undergone bariatric surgery, revisional surgery can be a necessary option to ensure continued health and weight management success. Bariatric surgery, though effective, is not always a permanent solution, and many factors—such as surgical technique, post-operative lifestyle, or medical conditions—can influence long-term outcomes. Revisional bariatric surgery allows for adjustments that can help patients better achieve their health goals, manage complications, and address any mechanical or physiological issues that may have developed after the initial surgery.

Revisional Bariatric Surgery in Australia

In Australia, bariatric surgery has grown in popularity as a tool to combat obesity and its associated health risks, with over 16,000 procedures performed annually. While most patients achieve significant weight loss and improvement in obesity-related conditions, studies show that some may require a revisional procedure. Up to 20% of patients undergoing gastric banding, for instance, may need revision due to complications or inadequate weight loss. In contrast, revisions are less common in gastric bypass or sleeve gastrectomy patients. Understanding the prevalence and reasons for revisional bariatric surgeries can help patients and clinicians make informed decisions about managing weight and health post-surgery.

Symptoms Indicating the Need for Revisional Bariatric Surgery

Persistent or new abdominal pain
Regain of weight or insufficient weight loss
Difficulty in consuming food or chronic nausea and vomiting
Persistent reflux or heartburn
Malnutrition or nutrient deficiencies despite supplementation

Causes for Revisional Bariatric Surgery

Anatomical changes over time, such as dilation of the gastric pouch or slippage in adjustable gastric bands
Insufficient weight loss or weight regain due to factors like metabolic adaptation, lifestyle, or surgical complications.
Complications from the initial surgery, such as severe acid reflux, ulcers, or chronic gastrointestinal issues

Diagnostic Tests

To assess the need for revisional surgery, bariatric surgeons may utilise several diagnostic tools, including:

Upper gastrointestinal (GI) endoscopy to examine the stomach and small intestine
Imaging tests like an upper GI series or CT scan to visualise anatomy and check for issues such as dilation, slippage, or obstruction.
Blood tests to monitor nutritional status and check for deficiencies

Complications if Left Untreated

Severe nutritional deficiencies, potentially leading to anemia, osteoporosis, and other health issues.
Continued or worsened symptoms such as acid reflux, abdominal pain, or dysphagia (difficulty swallowing)
Mental health effects due to weight regain or unmet weight-loss expectations
Risk of progression to obesity-related illnesses like diabetes, heart disease, and hypertension

Treatments

The type of revisional surgery depends on the initial procedure and the specific issues being addressed. Common options include:

Adjustable gastric band removal or repositioning
Conversion of a gastric band to sleeve gastrectomy or gastric bypass
Revisions to Roux-en-Y gastric bypass to manage complications like reflux

For those considering revisional bariatric surgery, consulting a qualified surgeon experienced in primary and revisional procedures is crucial to attaining an optimal outcome.

For more information or to book a consultation with Dr Craven, please call us on (03) 9852 3777 or email us at info@dralexcraven.com.au.

Dr Alex Craven Provides Specialised Care In

Surgery for Obesity

Upper Gastrointestinal Surgery

General Surgery

Endoscopy

Weight and Obesity Control

Frequently Asked Questions

Who is eligible for revisional bariatric surgery?

Patients who experience insufficient weight loss, significant weight regain, or medical complications after their first bariatric procedure may be candidates for revisional surgery. Each case is unique, and eligibility is determined after a thorough evaluation.

How effective is revisional bariatric surgery?

Revisional surgery can be very effective for symptom relief, improved health outcomes, and further weight loss. However, success rates may vary depending on factors such as surgical technique, patient health, and adherence to post-operative guidelines.

What risks are associated with revisional bariatric surgery?

While revisional surgeries can be effective, they may carry higher risks than initial procedures due to scar tissue, altered anatomy, and other complexities. Potential risks include infection, bleeding, leaks, and nutritional deficiencies. A skilled bariatric surgeon will work to minimise these risks.

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