According to the U.S. National Library of Medicine National Institutes of Health, revisional surgery for bariatric procedures are increasing. This is due in part to the current rise in weight loss surgeries, which also results in a rise in the revisions. Revisional procedures are done after bariatric weight loss surgery to either repair the procedure or alter it in some way. It is known as a corrective procedure, which can adjust the type of weight loss surgery originally performed or completely reverse it in some cases. There are different types and techniques performed, while some medical centers prefer the less invasive ones, such as StomaphyX. At the Ohio State University Medical Center, they have performed the first revision surgeries following bariatric surgery that does not include incisions during the procedure.
There are four main types of revisional surgery procedures following weight loss surgery: adjustable gastric band, StomaphyX, Roux-en-Y gastric bypass and sleeve gastrectomy. The adjustable gastric band is a lap band originally performed to lessen the size of the stomach. If an adjustment needs to be performed, it is known as a revisional surgery. This is one of the most common and less invasive types. Next, is a more revolutionary procedure called StomachyX. It is an endoscopic procedure that tightens the pouch recently done through a Roux-en-Y gastric bypass. One of the more popular types of revision surgeries is, in fact, the Roux-en-Y, which helps patients lose weight if their previous procedure isn’t showing the best results. The sleeve gastrectomy removes part of the stomach to leave a tube-like shape left. It reduces appetites and helps improve weight loss.
Each of these revisional surgeries is performed differently. They are all done under general anesthesia and begin the same way as their original weight loss procedure, with incisions in the abdomen and done with a laparoscopic camera. Revision surgeries don’t take longer than 1-2 hours in total.
After the revisional procedure is complete, expect to remain in the hospital for 2-3 days. During this time, the medical staff will keep a close eye on you and look for signs of infection or other complications. You will be put on a strict liquid diet for the first 2-3 weeks until your body begins to recover. After that, you will be allowed soft foods slowly, starting with them being pureed. Solid foods should only be added after your surgeon has approved it and in small quantities. Gradually increase the types of foods you eat to avoid further discomfort or complications. After two weeks, you will be able to perform your normal, daily activities, but avoid more excessive physical activity for six weeks, or until your doctor approves it.
Just like with your original weight loss surgery, you will be eating several small meals a day. You should be used to the full feeling by now and make sure you do not eat when you’re not hungry. Expect a reduced appetite and only a very small amount of food eaten for each meal, especially in the beginning. Do not attempt to add solid foods or eat higher quantities of food until your doctor gives the okay.
While risks and complications only occur for a very small percentage of patients, you should be aware of the implications. Revisional surgeries do tend to have more risks than the original weight loss surgery. Some possible risks following this procedure include blood loss, open incisions, the procedure itself taking longer, infection, or leaks from the incision site. If your incision site feels especially hot or is getting redder, it may be an infection. You should see your surgeon right away. To reduce your risks, follow the surgeon’s aftercare instructions exactly. Do not attempt strenuous activities too soon, eat what is recommended to you and take your medications as instructed. Quitting smoking is highly recommended because tobacco is known to slow the healing process. If you take any medications, let your surgeon know before the procedure. They will most likely recommend you stop taking them about 2-3 weeks before you go under anesthesia.