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Do You Need Weight Loss Surgery Revision?

The Khalili Center founder, Theodore Khalili, MD, FACS, is one of the United States’ (US) leading authorities in revisional weight loss surgery

 

Dr. Khalili has performed more revisional surgery procedures than most doctors in Southern California. He has also done over 8,378 successful bariatric surgeries, including the US’s first robot-assisted gastric bypass.

When to Consider Weight Loss Surgery Revision

Weight loss operations are generally successful. However, some procedures require revisions for several reasons, including:

  • Device-related problems – Sometimes gastric banding devices, such as the LAP-BAND®, no longer induce long-term weight loss. Some gastric bands also need adjusting, therefore requiring band revisions.
  • Inadequate weight loss or weight regain
  • Medical complications – Some patients experience co-morbidities, such as unrelenting heartburn after sleeve gastrectomy, ulcers, and scar tissues
  • Anatomic and nutritional complications – These problems are usually caused by outdated weight loss surgeries, such as jejunoileal bypass or stapled gastroplasty. Some patients experience malabsorption of nutrients, such as vitamin B, vitamin B12, and thiamine.
  • Anatomic changes in patients – Over time, the stomach stretches, causing individuals to consume even more food after their primary bariatric surgery. Some patients also develop an enlarged gastric pouch opening. 

The Khalili Center surgeons are experts in determining if patients need revisions to their initial surgery following patient weight gain or development of medical conditions. Through a comprehensive assessment, we help you decide if surgical correction is the best option to achieve your weight loss goals.


What Is Weight Loss Surgery Revision?

Revisional weight loss surgery is a weight loss procedure that aims to correct issues associated with initial weight loss procedures. This procedure should be performed by bariatric surgeons with an advanced skill set, such as Dr. Khalili and the team.


Types of Bariatric Surgery Revision Procedures

There are several surgical options the Khalili Center offers to address insufficient weight loss and medical complications from primary bariatric procedures. These surgeries include:


Choosing the Right Revision Procedure for Your Bariatric Surgery

Our experienced surgeons at the Khalili Center conduct initial consultations with patients to determine potential candidates for surgery. We also require our patients to undergo a series of diagnostic tests to ensure the bariatric revision surgery’s long-term success.

Our nurses also discuss the details of these examinations and consultations so you can arrange with your primary healthcare provider if they can cover the necessary tests.


Gastric Bypass Revision Surgery

Gastric bypass, or roux-en-y gastric bypass, is the gold standard of bariatric surgery. However, changes in the body and other circumstances can lead to the ineffectiveness of this surgery option. For some gastric bypass patients, the stomach stretches, which is a natural post-op occurrence.

However, the stretching can cause individuals to eat more and gain more weight. Thus, gastric bypass revision surgery is required. Gastric bypass revision cases vary, so the Khalili Center experts assess the best revision for this type of surgery per case. 

A successful gastric bypass revision can result in patients absorbing less food and losing around 70% of their excess weight(1).


How Gastric Bypass Revision Surgery Works

There are several options to address gastric bypass surgery issues. The Khalili Center surgeons can place a gastric band around the stomach to restrict food intake.

They can remove a portion of the stomach pouch, reduce the intestine passageways’ size, and restrict the amount of food patients can ingest. Our surgeons can also bypass more intestines to induce malabsorption of calories in patients. Surgeons can perform a revisional surgery laparoscopically. This minimally-invasive procedure makes use of a small, high-resolution camera to tighten the connection between the intestines and the stomach. The tighter this connection, the less the patient eats. 

LAP-BAND Revision Surgery

This revision procedure is one of the most common surgical revisions. It is necessary if the initial procedure has stopped inducing weight loss. Some gastric bands also slip or erode, causing discomfort in patients.


How LAP-BAND® Revision Surgery Works

The Khalili Center surgeons follow a standard procedure of careful assessment before prescribing any surgical procedure to patients. For LAP-BAND® revisions, our experts require an X-ray of the stomach and esophagus. The X-ray results help our surgeons assess which surgical option is best. Usually, patients who need this type of revision undergo sleeve gastrectomy or gastric bypass.

Our surgeons remove a stomach portion during sleeve gastrectomy (gastric sleeve surgery) and create a sleeve or tube-like structure. This operation leads to a reduction in the size of the stomach and changes the hormones that affect appetite.

Another option our surgeons can perform during gastric band surgery revision is gastric bypass. During this procedure, they create a stomach division: a small upper pouch where food is processed and a large portion of the stomach that is bypassed. The Khalili Center surgeons connect the small intestine to the small pouch, affecting the patient’s appetite.


Gastric Sleeve Revision Surgery

Revisions to gastric sleeve surgery are required for several reasons, including:

  • Complications arising from the surgical technique
  • Stomach stretching 
  • Chronic issues from the gastric sleeve
  • Patient’s failure to apply the necessary lifestyle changes and follow strict nutritional guidelines 

Some patients who undergo gastric sleeve surgery also report the development of acid reflux. Correcting the gastric sleeve’s shape is essential to minimize acid reflux. Skilled surgeons, such as the Khalili Center doctors, are vital to ensure surgical revision success.


How Gastric Sleeve Revision Surgery Works

At the Khalili Center, we present our patients with several surgical options after a thorough evaluation of their cases. Individuals seeking gastrectomy revisions can choose from conversion to gastric bypass surgery or a re-sleeving. Gastric bypass is useful for patients who have acid reflux. The chances of treating the reflux and experiencing significant weight loss are higher with this type of revisional procedure. Meanwhile, re-sleeving could involve resizing the sleeve into a smaller size through the stretched sleeve segment’s stapling. 


What to Expect

Revisional surgery outcomes vary, depending on the previous surgical procedures performed. However, patients who undergo such corrective surgeries should eat fewer amounts of food. A significant amount of weight loss should be expected. However, in some cases, revision surgery weight loss is not as dramatic as the initial weight loss one can experience after the first bariatric procedure.

After the Khalili Center surgeons correct your bariatric procedure, you can expect an improvement in your overall health and quality of life.  Most patients also experience increased life expectancy and management of obesity-related medical conditions, such as diabetes, hypertension, and sleep apnea. In two to three days after surgery at the Khalili Center, most patients can go home and restart their weight loss journey.

Recovering From Weight Loss Surgery Revision

Compared to your original surgery, recovery time after a weight loss surgery revision can take longer because of the risk of developing scar tissue and changes to your blood supply. 

 

Our surgeons recommend staying at the Khalili Center for two to three days for careful monitoring before continuing recovery at home. After your release, you can go back to your routine in a few weeks. 

We recommend strictly following our post-surgery guidelines for shorter recovery time. At the Khalili Center, we prescribe a liquid diet for the first two weeks. Then, patients can introduce soft foods into their diet. 

To manage pain and acid reflux, our experts also prescribe medications, such as painkillers. We discourage newly-released patients from engaging in strenuous physical activities, particularly during the first few weeks after surgery. However, patients can go back to work a week after the procedure.

Some patients may experience regurgitation, nausea, acid reflux, diarrhea, or constipation. These occurrences are generally normal. Still, we encourage patients to inform their assigned physicians if they experience any of these symptoms.

We ensure that patients have a smooth recovery through careful monitoring and follow-ups.

FAQs

What Are the Risks of Weight Loss Surgery Revision?

 At the Khalili Center, we do our best to give you risk-free surgery. However, our clients must be aware of the possible complications during revision weight loss surgery, including:

 

  • Infection
  • Leaks
  • Longer surgery time compared to the patient’s first bariatric procedure
  • Open incisions
  • Blood loss

We are confident that our specialists can minimize the risks that come with any surgical procedure. With the Khalili Center’s aftercare program, patients should expect follow-up consultations to monitor their progress and ensure that they do not develop any of these risks.

Can You Have Weight Loss Surgery Twice?

Yes. Bariatric procedures are generally successful if done by established medical centers, such as the Khalili Center. However, some cases require surgical revisions.

Does Insurance Cover Revision Surgery?

Medical insurance companies have different requirements. However, most of them cover surgical revisions to bariatric procedures that were initially performed.

Typically, they cover the surgery costs of individuals with a body mass index (BMI) greater than 40. These companies also pay for the revisional procedure of individuals with a BMI of 35 and have developed medical conditions related to obesity.

The Khalili Center offers free insurance verification. We encourage patients to confirm with their health insurance providers and see if their plan includes bariatric surgical costs.

We also provide financing options for patients whose medical insurance providers are unable to cover their expenses. The Khalili Center has partnered with the premier financing company Prosper Healthcare Lending to empower patients to go through with their procedure.

To date, this lending company, trusted by the healthcare industry, has made over 250,000 people’s procedures possible. The Khalili Center is committed to guiding patients through every step of getting back on track in their weight loss journey. It all begins when you book a consultation with us by calling 310-246-9083 today!

References

  1. Gastric Bypass Revision. (n.d.). Retrieved September 15, 2020, from http://surgery.ucla.edu/bariatrics-gastric-bypass-revision

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