Revisional Bariatric Surgery in Punjab, India-Dr.Amit Garg | Fortis Hospital (Mohali)

Revisional bariatric surgery in Punjab encompasses additional surgical interventions performed on patients who have previously undergone any form of weight-loss surgery. These procedures fall into three main categories: correction or modification, alteration, and reversal. Such follow-up surgeries aim to enhance the efficacy of the original procedure and improve the patient’s quality of life, particularly if the initial surgery led to undesirable side effects.

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Approximately 7% to 15% of individuals who have undergone bariatric surgery may require revisional procedures. The decision to pursue revisional bariatric surgery is made after a thorough evaluation of the patient’s overall health, progress in weight loss, and any emerging quality-of-life concerns that have surfaced since the initial surgery.

Revisional bariatric surgery is a broad term encompassing follow-up procedures necessary for patients who have previously undergone weight-loss surgery. These additional interventions aim to enhance the effectiveness of the initial weight-loss sleep apnea procedure, alleviate adverse side effects, or reverse the original surgery if needed.

There Are Several Reasons Why A Patient Might Be Considered For Revisional Bariatric Surgery
  • Insufficient Weight Loss: Some patients may not achieve the expected amount of weight loss within a specified period after surgery. If they lose less than 15% of their total body weight, they may be candidates for revisional surgery.
  • Complications: Complications can arise from the initial bariatric procedure, such as gastric band slippage, erosion, or leakage, gastric fistula, hiatal hernia, ulcers, or strictures.
  • Side Effects: Patients may develop side effects after the initial surgery, such as acid reflux, difficulty swallowing, or symptoms like GERD.
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  • Weight Regain: Weight regain can occur post-surgery, possibly due to issues like dilation of the gastrojejunal anastomosis after gastric bypass surgery.
  • Malnutrition: In some cases, the initial surgery may lead to malnutrition, vitamin deficiency, or hypocalcemia due to insufficient nutrient absorption. Revisional surgery may involve modifying or reversing the procedure to address these issues, especially if liver failure accompanies malnutrition.

Revisional bariatric surgery aims to address these concerns and improve the patient’s overall outcomes following weight-loss surgery.

How Does Revisional Bariatric Surgery Function?

The approach to revisional bariatric surgery varies depending on the issues that arose following the initial procedure and whether surgeons intend to repair, convert, or reverse the original surgery.

These Revisional Options Are Commonly Applied To The Three Main Types Of Bariatric Surgery
  • Sleeve Gastrectomy: Initially, this procedure involves surgically removing a significant portion of the stomach, reducing its volume by 80%. Over time, the stomach may stretch or enlarge, leading to weight regain. To address this, surgeons typically convert sleeve gastrectomy to gastric bypass or a duodenal switch procedure. Converting to gastric bypass can also effectively manage GERD symptoms that may have developed post-surgery.
  • Gastric Bypass Surgery: During this procedure, a small pouch of the upper stomach is sectioned off to hold food, and part of the small intestine is rerouted to this pouch. Over time, the pouch may stretch or enlarge. This can be corrected surgically, endoscopically, or through anti-obesity medications. Additionally, gastric bypass can be converted to a Single Anastomosis Duodenal-Ileal Bypass with Sleeve Gastrectomy (SADI) or reversed by reattaching the stomach, performing a gastric sleeve, and reattaching the previous small bowel while attaching a loop of the small bowel to the end of the gastric sleeve.
  • Gastric Band Surgery: Also known as Lap-band surgery, a silicone belt is placed around the upper stomach to divide it into two sections, helping patients feel full sooner. If the band slips out of place, surgeons may reposition it or remove it temporarily before replacing it. Alternatively, gastric band surgery can be converted to sleeve gastrectomy, gastric bypass surgery, or the SADI procedure.

Revisional bariatric surgery aims to address complications or insufficient outcomes from the initial procedure, improving the patient’s overall health and well-being.

Revisional bariatric surgery is utilized to address complications, insufficient outcomes, or undesired effects stemming from a previous bariatric surgical intervention. Initial bariatric procedures are often recommended for individuals with obesity as an effective means to achieve and sustain weight loss. However, various circumstances may necessitate follow-up surgery to rectify these issues.

Dr Amit Garg

Minimal Access Bariatric
Metabolic & GI Surgeon

BARIATRIC SURGERY IN INDIA I Dr AMIT GARG I BEST WEIGHT LOSS SURGEON IN PUNJAB INDIA

What Are The Potential Risks Of Revisional Bariatric Surgery?

The Benefits Of Revisional Bariatric Surgery Include:
  • Improved Health: The procedure aims to enhance the patient’s health and overall well-being. It may facilitate further weight loss in cases where the initial surgery did not yield the anticipated reduction in excess body weight.
  • Enhanced Quality of Life: Revisional surgery can alleviate or eliminate undesirable side effects that manifest after the initial bariatric procedure, such as gastroesophageal reflux disease (GERD) or difficulties with swallowing.
  • Complication Management: It addresses complications arising from the initial bariatric surgery, such as ulcers or strictures, thereby promoting better postoperative outcomes.
  • Reversal Option: In situations where the initial bariatric procedure is no longer desired or effective, revisional surgery offers the possibility of complete reversal, providing patients with alternative treatment options.
What are the potential risks of Revisional Bariatric Surgery?

Some revisional bariatric procedures are conducted through open surgery, which entails a heightened risk of bleeding, increased pain at the incision site, and a lengthier recovery period compared to minimally invasive laparoscopic surgery.

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Revisional bariatric surgery carries a higher risk profile compared to initial bariatric procedures. It is associated with elevated rates of complications and mortality. Additionally, patients undergoing revisional surgery are less likely to achieve the anticipated percentage of excess body weight loss. In some cases, revisional surgery may not adequately address the issues that arose following the initial procedure. Nonetheless, for many patients, revisional bariatric surgery proves beneficial in facilitating weight loss and enhancing quality of life.

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