If the patient has lost less than 50% of his excess weight within 18 months after the first bariatric surgery;
If long or late complications have developed due to the first operation;
After losing weight, If the patient has gained weight, the first operation is considered unsuccessful and revision surgery is on the agenda.
Many bariatric surgeons have changed a restrictive surgical procedure that has failed to a malabsorptive or combined (restrictive + malabsorptive) method. It prefers to rotate.
In addition to being a gastric sleeve restrictive surgery, it also affects the metabolism in terms of metabolism as it increases GLP-1 and peptide YY levels after the surgery. This feature distinguishes it from other restrictive obesity 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).
Revisional sleeve gastrectomy (re-sleeve) failed or complicated gastric banding, re-growth of the stomach after the first sleeve gastrectomy operation. It has become a considerable method for revision surgery in suitable patients in cases of gastric banding and after duodenal switch / pancreaticobiliary diversion operations.
Revision surgery after unsuccessful gastric banding is generally recommended 3-6 months after the band is removed.
Since it has fewer complications than the gastric (stomach) bypass operation used for revision and its results are satisfactory, sleeve gastrectomy (re-sleeve) surgery can be applied for revision in the appropriate patient group. sleeve) Indications:
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Weight gain after gastric banding
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Some complications due to gastric banding
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High risk patients that will require revision
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Obese patients with inflammatory bowel disease (especially Chron's)
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Advanced Patients with severe intestinal adhesion
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Smokers
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Morbidly obese patients in adolescence
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Older age patients
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Patients who may need to undergo a second surgical procedure other than obesity surgery
Adjustable stomach It would be more appropriate to perform gastric bypass as revision surgery after the band is removed for patients whose esophagus movements are impaired due to excessive expansion of the esophagus after the band is applied.
Aspiration pneumonia due to advanced reflux, Barrett's esophagus (continuous esophagus due to reflux). It is necessary to perform gastric bypass for revision surgery in patients with changes in the cells in the last part of the esophagus due to inflammation) and chronic cough due to reflux.
Metabolic syndrome after restrictive surgical procedures (band insertion, gastric sleeve, etc.). It would be more appropriate to apply gastric bypass to patients who have severe reflux and stomach stenosis after sleeve gastrectomy surgery.
It is necessary to apply gastric bypass for revision to patients with severe reflux and stomach stenosis after gastric sleeve surgery.
For obese patients who cannot adapt to their eating habits, it is more appropriate to perform gastric bypass instead of gastric sleeve (re-sleeve) for revision.
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