Dr. Hector Perez, Bariatric Surgeon, Cancun
Dr. Hector Perez is an experienced board certified surgeon specializing in bariatric weight loss surgery in Cancun. Today he discusses bariatric weight loss revision surgery.
Hello. My name is Dr. Hector Perez. I’m a bariatric surgeon here in Cancun with Ready4aChange. The topic of today is going to be revision surgery, something that’s getting more common because bariatric surgery has been around for more than twenty years.
There are many patients who used to have a lap band and they have revised their surgery to a gastric sleeve or gastric bypass, or patients who had a gastric sleeve and they want to change to a gastric bypass. This is an important topic, but also a difficult one.
What Would Cause a Gastric Sleeve to Fail?
One of the questions we get is, “What would cause a sleeve to fail?” This is not easy to hear for patients. The truth is that when a surgery fails, it’s not the surgery, it’s the patient. If the patient followed directions, listens to the nutritionist, eat what they should eat, in the amount they should eat, the surgery won’t fail. That’s talking about losing weight. Now, if a patient had a co-morbidity like diabetes or hypertension, and they got a remission and they got it back, that’s normal, that’s something you might expect. If a patient was type II diabetic, lost weight with a gastric sleeve, and three, four, five years after surgery he starts with high blood sugar again, that’s expected and it doesn’t mean that the surgery failed. It means that the patient has a very low pancreatic reserve and will need resume or restart medication.
What Can I Do to Reduce the Risk of Gastric Sleeve Failure?
Another question is, “What can I do to reduce the risk of my sleeve failing?” Once again, the only thing you can do is follow the guidelines. Watch your diet, exercise, and the surgery won’t fail. You got 80% of your stomach removed, and remember we also remove the ghrelin – that’s the hormone of hunger.
Are Some Gastric Sleeves Bigger than Others?
Another question we get asked is, “Do some surgeons make the sleeve bigger than the others?” Yes. In order for us to do sleeve surgery we use something that goes inside the stomach called a bougie. And the bougie varies in size. It can go from a 34 to 40. If a doctor likes to use a big bougie, like a 40, your stomach will end up being a little bit bigger. So before choosing your surgeon, just ask your surgeon what kind of bougie does he use and that will solve most of your problems.
What Happens if My Gastric Sleeve Stretches
Another question, “What happens if your sleeve stretches? Can it be revised?” Yes, it can be revised in two ways. We can do something called a re-sleeve that is putting again the bougie inside, stapling and removing the excess stomach that has grown, or sometimes what we recommend is doing the same, but converting the surgery to a gastric bypass. But yes, the gastric sleeve may be revised.
What if My Gastric Sleeve Isn’t Working?
Another question is, “What if my sleeve gives me no restriction at all?” That shouldn’t be the case. You used to have a whole stomach, now you have a 20% of a stomach, so you should have restriction. If you lose the restriction it means that your stomach has grown back a little bit and stomachs don’t grow by themselves. It means that you’ve been pushing your surgery, you haven’t been taking care of your surgery. But remember, we can revise that surgery and fix it for you.
Lap Band to Gastric Sleeve Revision Surgery
“Why should lap bands revise to a sleeve?” That’s not something that’s a must. It’s an option. Lap bands can be revised to a gastric sleeve, especially if the results with the lap band were good. We can revise your surgery to a gastric sleeve. But if the results to your surgery weren’t good, then we recommend to convert your surgery to a gastric bypass.
Gastric Sleeve to Roux-n-y Gastric Bypass Revision Surgery
And the last question is, “Is it possible to revise a sleeve to a roux-n-y gastric bypass?” And once again the answer is yes. If your sleeve failed and you are regaining weight, or you weren’t able to lose weight, a good option for you is gastric bypass.
I hope this answers your questions about revisions. Thanks for watching.