Revision of a Gastric Sleeve Bariatric Procedure
The gastric sleeve, also known as the sleeve gastrectomy is one of the most commonly performed bariatric surgeries in the United States. In fact, it is the third most performed surgery behind the gastric bypass and gastric band and the fastest growing of any procedure. The simplicity of the gastric sleeve along with the exceptional weight loss and disease improvement results is very appealing. The procedure is a very popular choice for both surgeons and those suffering from obesity.
If the sleeve begins to lose its effectiveness and the patient’s weight starts to creep up, there are ways that it can be revised. The first revisional surgical option for the gastric sleeve is to convert it to a duodenal switch. This is a relatively straightforward procedure as the gastric sleeve is, in fact, the first (restrictive) part of every duodenal switch procedure. By adding the malabsorptive component of the duodenal switch, excess weight regain can be reversed. In fact, patients may even be able to lose more weight than they initially lost with the gastric sleeve alone. Of note, nutritional restrictions for the duodenal switch are greater than those of the gastric sleeve, so patients should be aware of the necessary lifestyle changes.
Another option to revise the gastric sleeve is called a re-sleeve. This is where the gastric sleeve is performed for a second time. A second cut along the greater curvature is created, much in the same way as the primary procedure. A re-sleeve works exactly the same way as the original surgery and simply re-shrinks the stomach to the size that it was immediately after surgery – or slightly smaller. While a re-sleeve may seem straightforward, it is still major surgery and patients should treat it as such.
Some weight regain after the gastric sleeve, especially several years after surgery, is normal and can often be attributed to a slight stretching in the gastric pouch. For cases that do not warrant a surgical procedure, we suggest medically supervised weight loss, which can alter dietary and exercise regimens to get excess weight back under control.
As part of his dedication to long-term weight loss, Dr. Duncan has also developed a proprietary revisional bariatric surgery, addressing excess weight regain issues. If indeed you believe that you need your sleeve revised, please call us to schedule a consultation.