Weight loss surgery is a tool that can help patients lose excess weight and improve their overall health, but it’s not perfect. As with any medical procedure, bariatric surgeries have limitations, which can sometimes result in weight regain or other complications after surgery.
If you have experienced a failed weight loss procedure, you are not alone. The good news is that help is available. If a comprehensive medical evaluation does not reveal a treatable medical condition as the cause of your weight regain, surgical revision may be an option.
Here are some of the more common problems patients experience with bariatric surgery and revisional options for each.
Laparoscopic Adjustable Gastric Bands
This procedure became popular due to the fact that the lap band is easy to place with a low operative risk and is considered reversible. While some patients experience success with adjustable gastric bands, many encounter problems in the years following surgery, including the need for multiple adjustments, or “fills.” In some cases, the band causes the formation of scar tissue around the stomach. The band may also slip, leak or erode through the stomach. Due to these and other problems, about 50 percent of gastric band patients eventually need to have their band removed.
In addition to band removal, revision to another weight loss procedure — most commonly gastric bypass or gastric sleeve — is an option for many gastric band patients. Dr. McCarty has more than 20 years of experience performing surgical revisions and commonly performs band-to-sleeve revisions with excellent results for the patient. This procedure takes an endoscopic approach that usually requires a one-night hospital stay with a shorter recovery time compared to conventional laparoscopic surgery.
It is not uncommon for gastric bypass patients to regain about 10 percent of their weight loss in the five to 10 years following surgery, but continued weight regain can cause frustration and anxiety. Most commonly, gastric bypass patients experience weight regain due to a dilated gastric pouch and/or anastomosis of the pouch and small intestine, which is often the result of increased hunger and stretching of the pouch.
This is one of the most common problems we treat at McCarty Weight Loss Center, and it is our goal to help the patient lose every pound of weight they regained. Gastric bypass revision can also be performed using the NOTES (natural orifice endoscopic) approach, which typically requires a one-night hospital stay.
Vertical Banded Gastroplasty
A common procedure in the 1980s, the vertical band creates a small stomach pouch that limits food intake. Many patients who have had this procedure experience difficulty tolerating substantial solid food due to the formation of scar tissue caused by the band. In other cases, the pouch opens, resulting in a lack of food restriction and therefore weight regain.
The vertical banded gastroplasty is typically performed through an open incision, but problems with this procedure can be revised using laparoscopic and/or endoscopic techniques. Most common revisions for this procedure include a VBG-to-sleeve, gastric bypass or duodenal switch, and patients typically experience long-term results similar to those of a primary procedure.
In most cases, complaints regarding the gastric sleeve are due to the patient not reaching his or her expected weight loss goals after surgery. If surgical revision is recommended, the most effective options are sleeve-to-bypass or duodenal switch.
If you have had weight loss surgery in the past and are experiencing complications — or if you have not achieved the weight loss you expected or have regained weight — contact the McCarty Weight Loss Center today to schedule a consultation to discuss your options. We will begin with a comprehensive medical exam and study of your current anatomy to get an understanding of the reason for your complications, inadequate weight loss or weight regain. Our goal is always to help you see the results you hoped for and improve your overall health.