Obesity is a disease that surgery doesn’t cure. Gastric bypass or LAP-BAND® procedures jumpstart weight loss, and help many patients sustain that weight loss for the long haul. However, many factors go into maintaining weight loss: diet, exercise, family support and, of course, following physician guidelines. After surgery, patients often feel invincible, and believe the disease is cured or the weight will never come back. Some let their guard down.
For patients who have gained the weight back or who were not able to lose the amount of weight they wanted after bariatric surgery, New Jersey Bariatric Center® offers several revisional weight loss surgery procedures to patients who qualify. This includes LAP-BAND® removal and conversion to another weight loss surgery as well as gastric band over bypass.
Who is eligible for Revision Surgery?
Not all patients will be good candidates for revision surgery. New Jersey Bariatric Center® surgeons will review each case individually to determine whether a candidate is eligible. In addition, insurance companies require that patients must:
- Be at least two years post-op
- Have gained back at least 50 percent of excess weight lost, or have been unable to lose more than 50 percent of their excess weight
New Jersey Bariatric Center’s® surgical director will review your case, including medical records and weight loss history, and decide on a case-by-case basis whether you are a good candidate for a revision procedure.
Revision of Gastric Band (LAP-BAND Removal)
In some patients, the gastric band (LAP-BAND®) may fail to provide adequate weight loss, and the patient may be considered for band removal and conversion to another procedure. New Jersey Bariatric Center® offers the following surgeries to remove the band:
- Band to sleeve gastrectomy (gastric sleeve): In this procedure, after the band’s removal, about two-thirds of the stomach is taken out. The stomach is converted to a long tube about the size of a banana, limiting food intake and reducing the sensation of hunger. Visit the Gastric Sleeve page to learn more about gastric sleeve surgery.
- Band to gastric bypass: In this procedure, after removal of the band, the surgeon creates a small pouch at the top of the stomach, stapling it off from the rest of your stomach. The surgeon cuts the small intestine and sews part of it directly onto the new pouch. This limits both food intake and the amount of calories absorbed by the body. Visit the Gastric Bypass page to learn more about the gastric bypass surgery.
Revision of Gastric Bypass
Gastric bypass patients typically regain weight because of the stretching of the stomach pouch or through the stretching of the opening between the pouch and small intestine known as the stoma. There are three main techniques of revising a gastric bypass that has failed because of stretching:
- Gastric band over dilated gastric bypass pouch: During this procedure, the surgeon places a gastric band (LAP-BAND®) around the previously created stomach pouch or around the opening between the pouch and the intestine. After surgery, the gastric band is tightened by injecting saline into the band, causing the inner part of the band to expand. As the opening becomes narrower with subsequent adjustments, food stays longer in the stomach pouch, and once again patients feel satisfied with a small meal.
- Endoscopic plication: This newly refined technique allows the surgeon to reduce the size of the gastric pouch or the size of the opening between the pouch and intestine. This procedure can be done through the mouth (endoscopically), with no incisions and a quicker recovery time.
- Traditional bypass revision: This repeat surgery involves stapling the gastric pouch to a smaller size or taking apart and reconnecting the pouch and intestine to make that connection smaller. This procedure is only considered when other means of pouch narrowing are not clinically indicated. Because this procedure requires re-stapling, it may be associated with a higher complication rate.
If you are interested in learning more about bariatric revision surgery, call us at 908-481-1270 to speak to our Revision Surgery Coordinator or Contact Us to request a call back.