Revision Bariatric Surgery Reasons
Bariatric surgery is a well-established, safe and effective means for people with morbid obesity to lose weight and regain their lives. But these procedures are not 100% effective for 100% of patients. It is important to remember that obesity is a chronic disease and weight loss surgery is not a cure.
What are the primary reasons for revision surgery?
The most common reasons for revision surgery are weight regain, inadequate weight loss, failure of surgery to resolve comorbid diseases associated with obesity or complications. The failure to achieve weight loss goals means a weight loss of less than 50% or a BMI greater than 35.
What are the reasons for relapse?
Relapse may be due to any one or more of the following:
- The type of the original procedure – A perfect example is the lap band. It is a popular procedure because it is reversible.
- Not getting the expected results – Each type of procedure has its own failure rate. Wide variations in revision rates are related geographic location and operative volumes.
- Anatomy changes – Stomachs do stretch years after surgery. For instance, your stomach may stretch out allowing you to eat more before you feel full, so you gain weight.
- Personal changes – Changes in circumstances, behavior changes and attitude changes. New life stresses may include having children, leaving a relationship, financial hardships, and/or a new job. It is challenging to commit to and stick with a new lifestyle including incorporating a regular exercise routine, new eating habits, and stress management.
What area the revision rates by procedure?
Current published revision rates by procedure*:
- Lap band – 5.7% revision rate but may be as high as 26%. Weight loss goals for lap band surgery are 40-50% of excess weight loss. Major complications are stretching or slipping of the band.
- Sleeve surgery – Weight loss goals for sleeve surgery are a loss of greater than 50% of excess weight for the first 3-5 years, and weight loss maintenance comparable to that of bypass greater than 50%. 9.8% of patients who undergo the sleeve procedure will need additional surgery. Inadequate weight loss and severe acid reflux are the most common indications for revision surgery. Studies report that the stomach can double in size two years after the operation and as the stomach enlarges, you tend to eat more which leads to weight gain. This is all very natural and not your fault.
- Bypass surgery – 4.9% revision rate. Gastric bypass is the gold standard and most patients lose 60-80% of their excess weight and maintain greater than 50% excess weight loss. Almost 5% of these patients regain significant weight or fail to achieve weight loss goals. The stomach also stretches out after a Gastric bypass.
When you are regaining weight, or have inadequate weight loss, the very first thing to do is talk to your surgeon who will evaluate the possible causes of your problems. When you feel you are losing control, speak with our surgeon who can provide you with the resources to refresh your lifestyle, make better food choices, exercise more, and become recommitted. When revision surgery is indicated, it can put you back on track to achieve your weight loss goals.
Advanced Surgical and Bariatrics of NJ has one of the lowest complication rates in the Northeast due to our emphasis on quality care, cutting-edge surgical techniques, and superior safety standards.
Dr. Ragui Sadek is an international recognized authority in minimally invasive bariatric surgery. He and his team perform more than 1,000 complex procedures every year, with few post-surgery complications. Surgeons who perform a lot of bariatric procedures performed, have lower complication rates, and higher success rates.
When you are facing challenges with your surgery Advanced Surgical and Bariatrics of NJ can help. Our team of multispecialty physicians will help you get back on track and take charge of your life.
*Altieri MD, et al. Rate of revisions or conversion after bariatric surgery over 10 years in the state of New York. Surg Obes Relat Dis. 2018 Apr;14(4):500-507. Epub 2017 Dec 29.