Gastric bypass surgery is successful for the majority of patients who decide to undergo bariatric surgery. However patients who are dissatisfied with the results of their primary surgery may desire a gastric bypass revision surgery .
There are two main reasons for patient dissatisfaction with gastric bypass surgery. The first is that an unsatisfactory amount of weight has been lost. The second reason for patients seeking gastric bypass revision is dissatisfaction with weight regain.
Weight regain after bariatric surgery is not unusual. As many as 20% of morbidly obese patients and 35% of super obese patients have gained back more than 50% of the weight they had lost. The weight regain was within ten years after their gastric bypass surgery.
Causes for Weight Gain after Gastric Bypass
Gastric bypass weight regain can be due to bad eating habits or the gastric pouch stretching. A bariatric surgeon will want to rule out diet and exercise problems as the cause for weight gain before committing to a gastric bypass revision surgery.
Working with a dietician to keep track of what you are eating may be required. The dietician can guide you on re-establishing the bariatric diet and good eating habits. The dietician also may check your basal metabolic rate to determine the amount of energy you burn at rest. This is important because an extremely low basal metabolic rate will deter weight loss.
Once diet and exercise issues are ruled out as the causes, the bariatric surgeon will then check the size of your stomach pouch and stoma. Weight gain can occur if either the pouch or stoma have been overly stretched. If this proves to be the case then gastric bypass revision surgery is warranted.
Types of Gastric Bypass Revision Surgery
A common gastric revision bypass is to tighten the stoma. Options for tightening the stoma include the StomaPhyx or Rose procedures, and sclerotherapy. Read, “Sclerotherapy for Failed Gastric Bypass.”
Both the StomaPhyx and Rose procedures create circumferential folds like a purse string around the stoma substantially reducing its diameter while also reducing the size of the stomach pouch. Read about my experience with StomaPhyx.
Sclerotherapy is a series of injections done over a period of two to three months. The procedure is meant to promote scarring that will reduce the size of the stoma.
Many bariatric surgeons will place a gastric band over the gastric bypass pouch. Commonly referred to as “band-over-bypass” the gastric band is used to further restrict the volume of food able to be held by the gastric bypass pouch. Read about Carnie Wilson’s experience with this revision surgery.
Another type of gastric bypass revision lengthens the Roux limb, converting a proximal Roux-en-Y gastric by pass to a distal Roux-en-Y bypass. Read, Distal Gastric Bypass Revision Surgery to learn more. The risks from this surgery are greater than many other revision surgeries. It is usually considered only if the patient has a low metabolic rate.
A final option for gastric bypass revision is to convert to a duodenal switch. Duodenal switch surgery reduces the size of the stomach and reroutes the intestines. The patient will feel less hungry, feel full sooner after eating, and absorb fewer calories when they eat.
Gastric bypass revision is an effective method to address weight regain or inadequate weight loss. But remember that faulty diet and exercise habits may be the likely reason for weight regain. And lifestyle changes could produce the results you desire thereby waving the need for surgery.
Living larger than ever,
My Bariatric Life