Sleeve Gastrectomy Revision

There are two main reasons a revision may be appropriate after a sleeve gastrectomy. The first is a post operative complication. Second is inaequate weight loss after your initial procedure or weight regain beyond a nominal amount.

Correcting Complications

The primary complication is reflux but this can be the result of a stricture and it can also be manifested as difficult swallowing. In these cases, the revision involves converting to a gastric bypass. This is a straightforward operation that results in a lower pressure pouch that improves reflux and makes swallowing easier.

Reigniting Weight Loss

Revisions for weight regain include two categories that can be done simultaneously, if both are needed. The first category is reducing the size of the sleeve to restore restriction. In some patients, the sleeve gets bigger over time, or was larger than is optimal initially, and more food is able to be eaten before a sense of fullness is reached.

The most consistent way of restoring restriction is to re–sleeve the stomach. Re-sleeving means we place a tube down the sleeve and staple along the tube the same way as we do during a primary sleeve gastrectomy. This works fairly well to restore restriction, but it will often not lead to as strong of a feeling as the first surgery did. This is partly because nerves become dulled to the stretch feeling and even restoring anatomy will not fully restore this restrictive feeling.

Another option for sleeve patients is to convert to a Duodenal Switch. The Duodenal Switch is an operation that we do quite frequently in our practice and that has the best weight loss of all the surgeries we perform. The Duodenal Switch begins with a Sleeve Gastrectomy and then a small bowel bypass is performed in additon. Converting an existing Sleeve Gastrectomy to a Duodenal Switch simply involves doing the small bowel bypass. This procedure is low risk and can be done as a single anastomosis, meaning with one connection, which minimizes the risk of the operation. This surgery is done laparoscopically, usually using all the same incisions from the sleeve gastrectomy. It involves an overnight stay in the hospital or surgical center. This operation is generally less expensive than a re-sleeve procedure when done without insurance.

Pursuing a Secondary Procedure

Some insurance policies include revisional options while some do not. It is important that you familiarize yourself with the details of your policy. We do offer self pay pricing for all revisional procedures.

To be considered for a secondary bariatric surgery, our doctors will require a copy of your operative note from your first bariatric surgery to properly evaluate your anatomy and options moving forward.

Self-Pay Pricing for Revisions to Sleeve Gastrectomy

Pricing is subject to change dependent on, but not limited to, medical conditions and body mass index. Patients may not qualify due to medical conditions, and patients are also subject to BMI criteria. Please call our office if you have any questions.

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