If the patient has lost less than 50% of the excess weight within 18 months after the first obesity surgery, If long-term or late-term complications developed due to the first surgery, If he/she regained weight after losing weight, the first surgery is considered unsuccessful and revision surgery is considered. Many bariatric surgeons prefer to convert a failed restrictive surgical procedure to a malabsorptive or combined (restrictive + malabsorptive) method.
In addition to being a gastric sleeve restrictive surgery, it also affects the metabolism from a metabolic point of view as it increases the GLP-1 and peptide YY levels after the surgery. This feature distinguishes it from other restrictive bariatric surgeries. Due to these metabolic effects, it has taken its place among the revision surgical procedures that can be applied after failed restrictive operations (re-sleeve).
Re-sleeve operation has become a viable method for revision surgery in suitable patients after failed or complicated gastric band surgery, in case of gastric regrowth after the first sleeve gastrectomy and after duodenal switch / pancreaticobiliary diversion operations.
Revision surgery after a failed stomach band is generally recommended 3-6 months after the band removal. Gastric sleeve surgery can be applied for revision in the appropriate patient group, as the complications are less than the gastric (stomach) bypass operation used for revision and the results are satisfactory.
Re-sleeve Gastric Sleeve Indications:
- Weight gain after stomach banding
- Some complications related to the stomach band
- High-risk patients who will need revision
- Obese patients with inflammatory bowel disease (especially Chron)
- Patients having advanced intestinal adhesions
- Smokers
- Adolescent morbidly obese patients
- Advanced age patients
- Patients who can need to undergo a second surgical procedure other than obesity surgery should lose 70% of their weight.
It would be more appropriate to apply gastric bypass as a revision surgery after the band is removed for the patients whose esophagus movements are impaired due to excessive enlargement of the esophagus after the adjustable stomach band is attached.
Gastric bypass is required for the revision surgery in the patients having advanced reflux-related aspiration pneumonia, Barret’s esophagus (changes in cells in the last part of the esophagus due to persistent inflammation in the esophagus due to reflux) and chronic cough due to reflux.
It would be more appropriate to apply gastric bypass for the patients who do not have metabolic syndrome after restrictive surgical procedures (banding, tube stomach, etc.). Gastric bypass is required for the revision in the patients having severe reflux and gastric stenosis after gastric sleeve surgery. It is more appropriate to perform gastric bypass instead of re-sleeve for the revision in obese patients who have bad eating habits or cannot adapt to their eating habits.
Pre-Operation Preparation
- Blood Tests
- Whole Abdomen USG – Ultrasound
- Lung PA
- ECG – Heart Rhythm
- Cardiology Examination
- Internal Medicine Examination
- Chest Diseases Examination
- Gastroscopy
- Göğüs Hastalıkları Muayenesi
- Gastroskopi