Surgery for Weight Regain

Bariatric Surgery

Bariatric surgery (weight loss surgery) is an option for obese patients who have not succeeded following conservative measures for weight loss. Some of the techniques used in bariatric surgery include gastric bypass, laparoscopic gastric banding, laparoscopic sleeve gastrectomy, and laparoscopic roux-en y gastric bypass.

Complications of Bariatric Surgery

Though generally safe, bariatric surgery has its own set of complications with failure to lose weight or weight regain being one of them. Weight regain may be a consequence of a patient not adhering to the lifestyle modifications recommended by the doctor. It may also result from any unintended anatomical changes that may occur in a patient’s body following bariatric surgery or simply failure of the bariatric procedure.

Most patients who have been unsuccessful in losing weight or have weight regain following bariatric surgery can benefit from a revision bariatric surgery.

Revision of Failed Lap-Band

Patients not losing adequate weight or regaining weight even after multiple adjustments to their Lap-Band may be recommended for a revision bariatric procedure. During a revision procedure, the Lap-Band is removed from the stomach and a sleeve gastrectomy or gastric bypass surgery may be performed by the doctor depending on the patient’s condition. Sleeve gastrectomy is a restrictive weight loss procedure where the size of the stomach is reduced by cutting or folding a large part of the stomach. This reduces the food holding capacity of the stomach and most patients are benefited from a decreased level of hunger and early satiety. Gastric bypass is a combination of both restrictive and malabsorption techniques. During a gastric bypass, a small pouch is created above the stomach and a large portion of the stomach and the upper part of the small intestine (duodenum) are bypassed. This restricts the amount of food intake and reduces the number of calories and nutrients absorbed by the body resulting in more favorable weight loss results.

Revision of Failed Gastric Sleeve

A gastric sleeve (sleeve gastrectomy) is a restrictive bariatric procedure where the stomach is reduced to approximately 15 percent of its original size. It is often very effective but may fail to bring about the desired results in some patients. Such patients may benefit by a revision gastric sleeve procedure which involves the creation of a new smaller gastric sleeve. Another alternative may be a gastric bypass surgery. The original gastric sleeve may be left intact and a gastric bypass procedure may be performed which would result in a greater restriction of caloric intake and greater weight loss.

Revision of Failed Gastric Bypass

Gastric bypass works in two ways, by limiting the amount of food intake and by modifying the digestive process. Over time dilation of the stomach pouch or bypass opening may lead to failure of the procedure and weight regain. Such patients may benefit from a revision gastric bypass surgery. During this procedure, the stomach pouch is reduced back to the required size and in some cases, the bypassed section of the small intestine may be extended resulting in a lesser amount of calorie absorption and greater weight loss.