Do I Need a Gastric Sleeve Revision?

Gastric sleeve revision is a surgical procedure performed on patients who have previously undergone gastric sleeve surgery. While gastric sleeve surgery, also known as sleeve gastrectomy, is a highly effective weight loss procedure, some patients may require a revision to address specific issues or enhance the outcomes. Gastric sleeve revision surgeries can serve various purposes, depending on the individual’s needs and circumstances. They may involve resizing or adjusting the existing sleeve, converting it to a different bariatric procedure, or addressing complications such as weight regain, sleeve dilation, acid reflux, or inadequate restriction.

In Las Vegas, NV, the land of excess, patients may find it challenging to navigate their weight loss journey amidst a culture that often celebrates indulgence and temptation. The pressure to achieve and maintain a healthy weight can be particularly daunting, making the need for gastric sleeve revisions a common consideration for individuals in Nevada and beyond. Mustafa Ahmed, MD understands the challenges his patients face and how to address them effectively. With years of experience and a deep understanding of the unique dynamics of weight loss, Dr. Ahmed has become a trusted figure in the field of bariatric surgery. As the founder of Southern Nevada Bariatrics, he has dedicated his career to helping patients navigate their weight loss journey and achieve lasting results. To schedule a consultation call 702-626-0499 or fill out our online form.

From exploring the signs and indications that may warrant a revision to discussing the various types of revision surgeries available, we offer comprehensive insights into the process. Our blog also delves into the potential reasons why a gastric sleeve may not have achieved the desired long-term weight loss, and how revisions can provide an opportunity for renewed success.

Why Do Patients Require Gastric Sleeve Revision?

Embarking on a weight loss journey is a courageous decision that requires unwavering dedication and determination. For those who have undergone gastric sleeve surgery, this transformative procedure often represents newfound hope and a chance to regain control over their health and well-being. However, as with any surgical intervention, the journey to sustainable weight loss is not always a linear path.

The decision to undergo a gastric sleeve revision is not one to be taken lightly, just as the original decision to start your weight loss journey with a sleeve gastrectomy was met with serious consideration and deliberation. While gastric sleeve surgery is generally effective for weight loss, there are cases where individuals may require revision. Here are some common reasons:

Inadequate Weight Loss After Sleeve Gastrectomy

Despite initial success, some individuals may not achieve their desired weight loss goals with the gastric sleeve procedure. Factors that can contribute to suboptimal weight loss outcomes include:

Gastric sleeve revision can help address these challenges and provide an opportunity for enhanced weight loss.

Weight Regain After Sleeve Gastrectomy

Over time, some patients may experience weight regain after their initial weight loss. This can occur due to various factors, including:

Gastric sleeve revision aims to restore or improve the restrictive effect of the surgery, enabling patients to regain control of their weight.

Sleeve Dilation After Gastric Sleeve Surgery

In some cases, the sleeve stomach pouch may stretch or dilate over time, leading to reduced restriction and increased food intake. ^[1] This can result in weight regain or inadequate weight loss. Gastric sleeve revision can involve resizing or reshaping the sleeve to restore its original restrictive capacity.

What is Gastroesophageal Reflux Disease (GERD)?

While gastric sleeve surgery can alleviate symptoms of GERD for many patients, some individuals may develop or experience worsening acid reflux symptoms post-surgery. ^[2] Gastric sleeve revision may be performed to address this issue by converting the sleeve to a different bariatric procedure that reduces acid reflux.

Complications or Side Effects After Gastric Sleeve Surgery

Although rare, complications or side effects can occur following gastric sleeve surgery. These may include

Dr. Ahmed can correct or manage these issues and ensure the safety and well-being of the patient.

Individual Health Needs Leading to Gastric Sleeve Revision

Each patient is unique, and their health needs may evolve over time. Some individuals may develop new medical conditions or experience changes in their health that require a revision of their gastric sleeve surgery. Examples include conditions like

Signs and Indications for Gastric Sleeve Revision

If you have undergone gastric sleeve surgery but have not achieved the desired weight loss or have experienced significant weight regain over time, it may indicate the need for a revision. Despite initial success, some individuals may find that their weight loss plateaus or fails to meet their expectations, necessitating a closer evaluation of the procedure’s effectiveness.

Pay attention to any persistent or new symptoms that emerge after gastric sleeve surgery. These may include

Such symptoms could indicate complications or issues that require further investigation and potential revision.

If you notice that your sleeve stomach pouch feels larger or less restrictive, it may be an indication that a revision is necessary to address the stretched sleeve and restore its original function.

Emotional and Psychological Considerations

Undergoing a gastric sleeve revision is not only a physical journey but also an emotional and psychological one. It is important to recognize and address the unique emotional and psychological aspects associated with this process. Here are some key considerations to keep in mind:

Body Image and Self-Esteem

Weight loss journeys, including gastric sleeve surgery and revisions, can significantly impact body image and self-esteem. It is common for patients to have complex emotions about their bodies, both before and after surgery. 

With a revision, it is essential to prepare for potential changes in body shape, weight fluctuations, and altered physical appearance. Building a positive body image and cultivating self-acceptance are ongoing processes that can benefit from

Managing Expectations

Having realistic expectations is crucial when considering gastric sleeve revision. Understand that revision surgery is not a magic solution but rather a tool that can assist in achieving weight loss goals. It is important to have open and honest conversations with Dr. Ahmed about the anticipated outcomes, potential challenges, and the time it may take to see significant results. Adjusting your expectations and focusing on overall health and well-being rather than solely on the number on the scale can contribute to a more positive mindset throughout the journey.

Support Systems

Building a strong support system can make a significant difference during the emotional and psychological aspects of a gastric sleeve revision. Seek support from friends, family, or support groups who can provide encouragement, understanding, and motivation. Additionally, consider joining online communities or seeking professional counseling to address any emotional challenges that may arise. Having a safe space to share your experiences and receive support can help alleviate feelings of isolation and empower you on your journey.

Celebrating Non-Scale Victories

Remember that success is not solely measured by the number on the scale. Celebrate the victories that happen off the scale, such as 

Acknowledging and appreciating these achievements can boost your self-esteem and motivation, helping you maintain a positive outlook during your revision journey.

Conversion from Sleeve Gastrectomy to Gastric Bypass

Gastric sleeve revisions encompass various surgical options that aim to address specific concerns, complications, or inadequate weight loss outcomes following the initial gastric sleeve procedure. In some cases, a sleeve revision, also called re-sleeve gastrectomy, can help. It involves adjusting the size of the existing gastric sleeve to enhance its restrictive effect. Resizing the sleeve can be done by removing a portion of the stomach or creating a new smaller sleeve within the existing one, thereby restoring or improving the restrictive capacity.

For individuals who experience persistent or worsening acid reflux symptoms after gastric sleeve surgery, conversion to Roux-en-Y Gastric Bypass (RYGB) may alleviate or significantly improve acid reflux by rerouting the digestive tract. ^[3] Furthermore, RYGB is considered a more powerful weight loss procedure compared to the gastric sleeve. The combination of restriction and malabsorption achieved through RYGB can lead to more significant weight loss and help individuals reach their weight loss goals.

Dr. Ahmed divides the existing gastric sleeve to create a smaller stomach pouch. This pouch is similar to the one created during the initial gastric sleeve surgery. The small intestine is divided, and the lower end is connected to the newly created stomach pouch. This connection is known as the jejunojejunostomy and allows food to bypass a portion of the small intestine.

The upper portion of the small intestine is reattached to the lower part of the intestine, creating a Y-shaped configuration. This reattachment allows the digestive juices from the stomach and the food to mix further down the digestive tract.

Scheduling Your Consultation with Dr. Ahmed in Las Vegas

The consultation will begin with an introduction to Dr. Ahmed and his team. You will be asked to provide your medical history, including details about any previous weight loss surgeries, current health conditions, medications you are taking, and any relevant family medical history.

Dr. Ahmed will conduct a physical examination to assess your current health status and evaluate the surgical site from your previous gastric sleeve procedure. This examination may involve checking your weight, height, and body mass index (BMI), and examining your abdomen to assess the condition of the gastric sleeve.

Depending on your specific situation, Dr. Ahmed may order additional diagnostic tests or imaging studies. These may include blood tests, endoscopy, or imaging scans to assess the size, functionality, and potential complications of the gastric sleeve. These tests will provide a comprehensive evaluation of your condition and help Dr. Ahmed make informed recommendations.

If you decide to proceed with the gastric sleeve revision, Dr. Ahmed’s team will guide you through the necessary preparations. We will schedule your surgery, provide pre-operative instructions, and discuss any required dietary or lifestyle changes before the procedure. Ready to move forward with a consultation? Call 702-626-0499 to reach our scheduling coordinator today!

References

1. Lemmens L, Van Den Bossche J, Zaveri H, Surve A. Banded Sleeve Gastrectomy: Better Long-Term Results? A Long-Term Cohort Study Until 5 Years Follow-Up in Obese and Superobese Patients. Obesity Surgery. 2018;28(9):2687-2695. https://doi.org/10.1007/s11695-018-3248-2
2. El-Hadi M, Birch D, Gill R, Karmali S. The effect of bariatric surgery on gastroesophageal reflux disease. Canadian Journal of Surgery. 2014;57(2):139-144. https://doi.org/10.1503/cjs.030612
3. Langer FB, Bohdjalian A, Soheila Shakeri-Leidenmühler, Schoppmann SF, Zacherl J, Prager G. Conversion from Sleeve Gastrectomy to Roux-en-Y Gastric Bypass—Indications and Outcome. 2010;20(7):835-840. https://doi.org/10.1007/s11695-010-0125-z