Revision and Corrective Surgery

Post Operative Bariatric Surgery patients are not always successful in reaching their weight loss goals. This can be due to several factors.

Bariatric Surgery began in the 1950's. The operations were different than those commonly done today. The procedures were often less successful, and more likely to cause complications. Other reasons for weight loss failure include poor technique. Bariatric surgery is specialized and complicated. Preventing complications, managing complications and managing patients post operatively are equally challenging aspects of care. Doing this well requires training and experience. Research shows that many of the more serious complications associated with bariatric surgery occur during a surgeon's first 75 operations. Reasons for post operative weight loss failure include problems with the original surgery, as well as patient inability to comply with necessary life style changes.

Coastal Center for Obesity offers revisions to patients with post surgery weight loss failure. Patients may be candidates for Revision Surgery or Banded Revision surgery (LAP-BAND® on top of Bypass). Candidates must be screened carefully to determine cause of failure, and must also be evaluated for appropriate correction, and receive education to insure patient post surgical compliance.

Based on published experience including St. Lukes University Health Network ' the Revision of previous surgery to Gastric Sleeve leak rate is ~ 3% .Dr. Owens ' Inverted Corner Gastric Sleeve designed to reduce leak rates in primary sleeve surgery, is expected to also lower leaks in this type of Revision surgery.

Revision to Sleeve may be preferable to Gastric Bypass for the following reasons:

• No anatomic re arrangement
  
• Lower risk for bowl obstruction
  
• Easier to evaluate Gallbladder and Bile ducts if necessary after surgery.
  
• Less malabsorption of iron, vitamin B12 and calcium
  
• May be converted to other weight loss operations.
  
• Removal of excess stomach part of the stomach removed in Sleeve surgery is thought to produce the 'hunger hormone' grhelin, so long term hunger may be better controlled