Gastric sleeve surgery has become one of the most common surgeries performed to help facilitate weight loss. Many patients see a considerable amount of weight loss in the first 12 months. However, results vary, and not every patient experiences the same amount of weight loss. In some cases, gastric sleeve surgery does not produce the expected weight loss results or patients experience chronic unpleasant side effects. Approximately 10% to 30% of the people who have gastric sleeve surgery seek some type of revision within the first 24 months.
What Is Gastric Sleeve Surgery?
Gastric sleeve surgery (LSG) is a surgical procedure to help an individual with a body mass index (BMI) is 40 or above to lose weight.
During the surgery, approximately 80% of a patient’s stomach is removed and the remainder of the stomach is stitched back together. This makes the stomach much smaller and tube-shaped limiting the amount of food that can be eaten at one time. Gastric Sleeve surgery requires a 1-3 day hospital stay and between 4-6 weeks of recovery time.
Can You Get the Surgery Twice?
If you have had gastric sleeve surgery and have not been losing the weight you expected or are suffering unpleasant side effects you may wonder if you can get gastric sleeve surgery revision?
The good news is that you are able to get a revision to your gastric sleeve surgery to help continue your weight loss program and in some cases, the best solution may be a different type of procedure.
Why Would A Gastric Sleeve Revision Be Necessary?
There are a few reasons why a gastric sleeve revision would be necessary:
- The most common reason an individual would choose to have a gastric sleeve revision is that they have not lost the amount of weight expected in the traditional time frame. In rare cases, this may be due to the fact that not enough of the stomach was removed during the initial surgery.
- Another reason a revision might be done is due to weight gain after surgery. About ⅓ of all patients who have had gastric sleeve surgery experience weight regain between 2 and 5 years post-surgery.
- In some cases (less than 2%) gastric sleeve surgery may cause chronic side effects such as acid reflux or hiatal hernia. Often dietary changes or medication can be used to control these types of side effects but in rare cases, a revision can be done to help alleviate these types of symptoms.
What Causes Weight Gain After the Surgery?
According to the American Medical Association’s journal, 5 years after laparoscopic sleeve gastrectomy approximately 50% of patients had experienced a significant weight gain. Research has also shown that the failures in gastric sleeve surgery most often revolve around the patient’s lifestyle choices.
Failing To Follow Dietary Plan
The most crucial element for obtaining the maximum weight loss results after gastric sleeve surgery is portion control. If the patients’ are not paying attention to how much food they are eating, or they are consuming liquids too soon after eating, they might consistently be overeating which can enlarge and stretch out the stomach. As the stomach stretches out it will allow the patients to eat more food at each sitting causing the patient to gain weight and the stomach will continue to stretch. This becomes a revolving cycle until the stomach allows for larger portions resulting in more and more weight gain. It is possible for the stomach to stretch so much it almost reverts back to its original size.
Failing To Get Adequate Exercise
Second, to portion control, physical activity is a key element in losing weight and keeping it off. Gastric sleeve surgery is an aid to help individuals lose weight but the process requires the participation of the individual to be successful.
Failing to Utilize Support Systems
The causes of obesity are numerous, can be complex and it has often been classified as a disease. Researchers who have studied obesity have associated metabolism, genetics, stress, hormonal impairments, menopause, psychological and neurological reasons as contributing to obesity. It stands to reason that most people who have had gastric sleeve surgery were not able to maintain a healthy weight on their own, so how will they be able to successfully lose weight and keep it off without some type of support system.
After undergoing any type of bariatric surgery it is important to engage in different types of support groups. It is recommended the patient seek psychological assistance as well as support from family, friends, and others who have gone through the same procedure.
Doctors who perform bariatric surgery have one goal in mind – to help their patients become healthier individuals through weight loss. Many doctors require that their patients participate in ongoing support as criteria for surgery qualification. Your doctor can give you information on specific groups that can help you in your weight loss endeavor. You should not, and do not, have to go through this process alone.
How Do You Know If You Need A Gastric Sleeve Revision?
Gastric sleeve surgery is not in itself a weight loss plan, it is an aid to help a patient reach their weight loss goals. Making significant lifestyle choices and strictly adhering to them is what will most often result in success. You may need a gastric sleeve revision if you are:
- Not losing weight as expected – It’s fairly normal to gain a few pounds after surgery often referred to as “rebound weight” and usually occurs due to regressive lifestyle choices. If you have been rigorously adhering to your diet and exercise program and they’re not seeing the results you expect it is possible you are having complications from your gastric sleeve surgery.
- Re-gaining weight after initially losing it as expected can be a sign that the stomach has stretched out and needs to be reduced again.
- Experiencing Chronic Acid Reflux can be an unpleasant side effect that can not be alleviated through medication or dietary changes.
- Having Other complications from surgery
Can A Revision To Gastric Sleeve Surgery Be Done Another Way?
Yes, you can have a different type of bariatric revision surgery if your gastric sleeve surgery failed. Your doctor will discuss your options with you and recommend a plan to get you back on track.
If your gastric sleeve surgery has failed you may be able to have a revision using gastric bypass or mini gastric bypass, duel Duodenal switch, or another gastric sleeve procedure.
There is a fairly new non-surgical gastric sleeve option available called endoscopic sleeve gastroplasty (ESG) that may be an option.
What Is Endoscopic Sleeve Gastroplasty?
Endoscopic sleeve gastroplasty is a non-surgical procedure that reduces the size of the stomach using sutures instead of removing a portion of the stomach.
Similar to laparoscopic gastric sleeve surgery, ESG is performed under general anesthesia but the surgery time is much shorter, no hospital stay is required and recovery time is about a week. It is possible to use ESG to revise a former laparoscopic gastric sleeve.
Endoscopic Sleeve Gastroplasty (ESG) or Accordion Procedure: Everything You Need to Know
Dr. Chris explains what Endoscopic Sleeve Gastroplasty (ESG) procedure is, how it is done, and what its benefits are.
How Much Weight Can You Lose With the Procedure?
Most patients who have a revision to their gastric sleeve surgery lose between 55 to 75 lbs for every hundred pounds they are overweight.
Is Gastric Sleeve Revision Usually Successful?
Each patient’s results will be different and dependent on the type of revision they choose. Most patients can lose between 20 to 55% of the weight that they have gained back as a result of a revision. That being said, the surgical team will do their part, but the patient must also adhere to strict lifestyle changes (diet and exercise) in order for weight loss to be successful.
If you have had bariatric surgery and you have not lost the weight you had hoped to lose or you have gained back a significant amount of weight we are here to help you so reach out to us today.
We would love to personally speak with you about your weight loss goals and help create a plan to help you get there. Here at IBI Healthcare Institute, we are committed to partnering with you on your weight loss journey.