Revisional Bariatric Surgery
Revisional bariatric surgery corrects or converts a previous weight-loss operation when the first procedure has not delivered lasting results. Weight regain is possible after each of the three main procedures: Roux-en-Y gastric bypass, sleeve gastrectomy, and gastric banding. Because the anatomy has already been altered, a revision is more complex than primary surgery and is best performed by an experienced surgeon.
The effectiveness of bariatric surgery is well documented, and weight loss is quite feasible when the right surgical approach is selected. The true measure of success in bariatric surgery lies in maintaining weight loss over the long term. Extended follow-up examinations, spanning more than five years, are essential to validate surgical success. Patients who experience weight regain may opt for a revisional procedure, and the type of revision varies depending on the original surgical method used.
Why Choose Turkey for Revisional Bariatric Surgery?
Revisional bariatric surgery should generally be performed only by experienced surgeons. The advantage of Turkish surgeons lies in the number of surgeries they perform. This experience brings a few important advantages for patients.
Complexity of Revisional Surgery
Revisional bariatric surgery is generally more complex than primary bariatric procedures due to altered anatomy and the potential presence of scar tissue from previous surgeries. Experienced surgeons are better equipped to manage these challenges.Varied Patient History
Patients undergoing revisional surgery often have diverse medical histories, complications, and specific needs. An experienced surgeon is better prepared to customize the procedure to address individual patient factors.
Risk Mitigation
Revisional surgery carries a higher risk of complications than primary surgery. Experienced surgeons are skilled at identifying potential risks, taking necessary precautions, and responding effectively to complications if they arise.
Minimizing Further Surgeries
Revisional surgery may be a patient's last chance to achieve significant weight loss and resolve complications. A skilled surgeon can minimize the need for further surgeries by getting the procedure right the first time.
Beyond experienced surgeons, Turkey offers affordable prices, state-of-the-art healthcare facilities equipped with the latest medical technology, and multilingual medical staff. There is also no waiting list for revisional bariatric surgery in Turkey. Many international patients choose Istanbul for its high number of quality health facilities.
Cost of Revisional Bariatric Surgery in Turkey
The cost of revisional bariatric surgery can vary significantly depending on several factors, including the type of revisional procedure being performed. Because the price depends heavily on the patient's individual needs, consulting the doctor before receiving a quote is crucial. In Turkey, prices are almost one-third of those in European countries. Also, keep in mind that revisional surgeries cost slightly more than initial bariatric surgery.
A consultation with a bariatric surgeon is the most reliable way to get a personalized plan and learn the exact cost of the revisional surgery you need.
Who Should Have Revisional Bariatric Surgery?
The decision to have revisional bariatric surgery is made on a case-by-case basis and depends on several factors. Here are some scenarios in which revisional bariatric surgery may be considered:
Revision of the Band or Conversion to Other Procedures
Laparoscopic adjustable gastric banding (LAGB) is a successful approach that ensures significant weight reduction in severely obese individuals. Nevertheless, there is a growing demand for reoperations due to either inadequate weight loss or complications arising from the banding process. When faced with complications related to the band, various surgical alternatives must be evaluated, including band removal, repositioning, or transitioning to an alternative surgical procedure.
A crucial aspect to take into account is the timing of revision. The transition from LAGB to alternative procedures can be executed either as a one-step or a two-step process, contingent upon the presence of specific complications.
Revision of Sleeve Gastrectomy
If a patient did not achieve sufficient weight loss or has experienced significant weight regain after the initial sleeve gastrectomy, a revision may be considered.
Revision to Roux-en-Y Gastric Bypass
One common revisional option is converting the sleeve gastrectomy into a Roux-en-Y gastric bypass (RYGB). This involves creating a small stomach pouch and rerouting the small intestine to reduce calorie absorption.
Resleeve Gastrectomy
In some cases, a second sleeve gastrectomy may be performed to further reduce the size of the stomach and enhance weight loss.
Roux-en-Y Gastric Bypass (RYGB) Revision
RYGB remains the second most commonly performed bariatric surgery globally, accounting for approximately 15-20% of all such procedures. However, there are instances where RYGB may not yield the desired weight loss results or may result in weight regain over time. The reasons for weight regain can be attributed to factors such as increased food intake due to the stretching of the gastric pouch, dilation of the gastrojejunal anastomotic complex, enlargement of the gastric pouch, or the presence of a gastrogastric fistula. Nonetheless, it appears that changes in eating behavior, particularly hyperphagia (excessive eating), are the primary contributors to weight gain following RYGB. In most cases, salvage banding is chosen for revisional surgery. Salvage banding can be performed via laparoscopy, involving the placement of either an adjustable gastric band or a nonadjustable silicone ring (Minimizer Ring) at the level of the gastric pouch to restore the restrictive effect.
This article is not authored by a medical professional; however, it provides a concise overview of various medical procedures sourced from academic papers within the field of medicine. While it does not substitute for expert medical advice, it offers a valuable summary of the information found in scholarly literature, making it a useful resource for those seeking a general understanding of these medical procedures. It is essential to consult with qualified healthcare professionals for in-depth and personalized medical guidance.References
- The SAGES Manual: A Practical Guide to Bariatric Surgery Author(s): Ninh T. Nguyen, Eric J. DeMaria, Sayeed Ikramuddin, Matthew M. Hutter Year: 2008
- Bariatric Surgery: Technical Variations and Complications Author(s): Mervyn Deitel (auth.), Michael Korenkov (eds.) Publisher: Springer-Verlag Berlin Heidelberg, Year: 2012
- Review of Obesity and Bariatric Surgery: Essential Notes and Multiple Choice Questions Author(s): Subhash Kini; Raghavendra Rao Publisher: Informa Healthcare, Year: 2012
- https://www.who.int/news-room/fact-sheets/detail/obesity-and-overweight
