In revisional bariatric surgery, surgeons modify or repair an earlier operation. Patients whose previous bariatric surgery produced undesirable or disappointing outcomes are possible candidates for revisional surgery.
Many older weight loss surgeries have been associated with a high rate of revision. Patients undergoing a jejunoileal (intestinal) bypass often suffer from chronic diarrhea and severe nutritional problems. When performed, these surgeries often have to be revised or reversed. Another procedure, stapled gastroplasty, has resulted in a failure to lose weight due to complications and inherent limitations of the operation..
Complications with Newer Procedures
Today, surgeons rely on newer and more effective techniques for performing weight-loss surgery such as the Roux-en-Y gastric bypass and the Lap-Band. However, even here, complications and unsatisfactory results occur, especially when performed by inexperienced surgeons. Overall, ten percent (10%) of Lap-Band procedures have complications within the first two years including unsatisfactory weight loss or device-related problems. Gastric bypass has a 5-10% rate of complication during the five-year period after surgery including ulcers and unsatisfactory weight loss.
The UCSF Approach
At UCSF, our bariatric team conducts a thorough review of your case and will ascertain why the earlier operation failed. Such causes include a ruptured band, a displaced port with a Lap Band, a disruption of staples, or a stretched pouch with the Roux-en-Y gastric bypass. In cases where patients fail to lose weight despite an apparently "successful" operation, a new approach is needed.
Revisional bariatric surgery is generally more complex and has more risk than the initial operation. However, in the hands of a skilled and experienced bariatric surgeon, revisional surgery can improve the outcome and reverse the ill effects of prior operations. Our multidisciplinary team carefully evaluates each patient utilizing the full array of radiologic and endoscopic tools.