Every year, almost 50,000 Americans undergo gastric bypass surgery for the treatment of obesity. Many people think that after bariatric surgery, their weight loss woes are over but this is far from true. Bariatric surgery is just a tool that can help them lose weight, but maintaining a healthy weight is an ongoing process.
Most individuals lose a great deal of weight in the months following their gastric bypass but unfortunately, about 50% of them gain back at least 30% of what they lost before they reach the 24-month mark. Some experience even more significant weight gain.
Some of these individuals choose to have a second surgical procedure (gastric bypass revision surgery) to help them stop gaining weight and restart their weight loss. Will their experience be the same as during the first surgery? What can they expect in the way of recovery time for gastric bypass revision surgery? Today, we are going to answer these questions and more about gastric bypass revision surgery.
What Is Involved in Gastric Bypass Surgery?
To better understand the revision process, it is important to know how a gastric bypass is performed. Gastric bypass surgery is an invasive procedure that, when complete, not only restricts the amount of food an individual can eat but also limits the number of calories their body can absorb.
The surgery is done under general anesthesia and takes around two hours to complete. These days, most bariatric surgery is performed laparoscopically, which means four to five small incisions are made in the abdomen and tiny surgical tools are inserted into these openings to perform the procedure.
Historically, one longer incision was made and the “open” surgery technique was used. Laparoscopic surgery carries fewer risks than open surgery but it is still surgery that involves incisions and carries the risk of complications.
During the procedure, the bariatric surgeon reduces the size of the patient’s stomach by cutting away about 75%–80% of the stomach tissue and removing it. The stomach is then formed into an elongated, small pouch-like shape, and the edges are held together with surgical staples. Next, they reroute a portion of the digestive system so the food that is eaten skips or bypasses a major section of the normal digestive process. This keeps the body from being able to absorb all the calories or nutrients from this food.
Gastric bypass surgery is permanent and cannot be reversed; however, it can be converted to an even more restrictive situation with a duodenal switch.
Why Would Someone Need Gastric Bypass Revision Surgery?
Several different reasons would create the need for a patient to need a revision to gastric bypass surgery, including:
- Weight Gain
- Patients can experience weight gain after gastric bypass surgery because they did not commit to the necessary lifestyle changes to maintain a healthy weight.
Internal changes could have taken place since their original surgery has reduced the restrictive nature of the surgery. The changes that happen most frequently are:
- The stomach pouch becomes stretched and gradually gets bigger, allowing the patient to eat larger portions, which causes weight gain.
- The connection between the stomach and the small intestine becomes enlarged. This allows the stomach to empty more quickly and patients get hungry more frequently.
- Inadequate Weight Loss
- Sometimes patients don’t lose as much weight as they expected, even when they are doing everything right. It may be that the original bariatric surgery was not the best option for this patient.
- Unpleasant Side Effects
- Patients can sometimes develop complications or chronic side effects after bariatric surgery that will not subside, such as severe reflux. These patients may seek revision surgery to find some relief.
What Does Gastric Bypass Recovery Involve?
Age, general health, initial BMI, and the presence of any preexisting weight-related conditions can factor into the length of time required for your recovery. Being able to return to your normal routine following surgery and being fully recovered can be two very different things. It will help your recovery go much smoother if you have an idea of what you can expect after your surgery and are sufficiently prepared. Your gastric bypass recovery time will typically involve these steps:
- After gastric bypass surgery, patients typically need to stay in the hospital for two to three nights. Right after the surgery, you are taken to a recovery area and monitored until they feel you are ready to go to your hospital room.
- You may wake up in the recovery area with an IV drip of pain medication to help keep you comfortable.
- You will have several small incisions in your abdomen that were used as access points for the surgeon to reach the surgical site. They will be stitched closed and may be covered in surgical dressings and maybe surgical tape.
- Some patients experience a negative reaction to general anesthesia and vomit or feel nauseous for a few hours after waking up from surgery.
- Your throat may feel a little tender from the breathing tube that is used during the gastric bypass procedure. You will be given ice chips that can help ease any throat discomfort. These will also be a bit helpful because you will not be permitted to drink or eat anything until the day after your surgery.
- As soon as you are able, you will be encouraged to get up and walk. This is a normal part of recovery for any type of surgical procedure and will help keep the blood flow circulating to reduce the risk of DVT (blood clots). Usually, the morning after your surgery, you can have clear liquids and you will have to follow a very strict special diet before working your way back up to eating solid foods.
- Once they feel you are ready, you will be discharged into the care of a friend or family member who will drive you home. You will need someone to stay with you for a few days during the early stages of recovery.
- Your surgeon will provide you with specific aftercare directions for your procedure and condition. You must follow these directions precisely to ensure you heal fast and properly. You will be instructed on wound care, the details of your pain medicine, when you may begin bathing, how much preventative walking to do, the dietary restrictions you must follow over the coming months, driving, and what you can do and should avoid in regards to lifting, housework, exercise, etc.
- The recovery time is between four and six weeks for laparoscopic gastric bypass surgery and can be as much as eight to ten weeks for open gastric bypass surgery.
How Is Revision Surgery Done And What Is The Recovery Time For Gastric Bypass Revision Surgery?
The technique used for the revision surgery may depend on how your initial procedure was done; however, most will be performed laparoscopically. Some of the options for gastric bypass patients include
- Sleeving the bypass
- Surgery that removes some of the existing pouch and narrows the diameter of the connection between it and the intestines using surgical staples
- A band is installed around the top portion of a stretched-out stomach to provide further restriction.
- The gastric bypass surgery is surgically converted to a duodenal switch, which adds more of the malabsorptive benefits by bypassing a larger portion of the digestive process.
These surgical revisions carry risks and complications just as the initial surgery did; however, if you have scarring from your initial bariatric surgery, the risks associated with a revision increase, such as the possibility of bleeding.
In some cases, recovering from gastric bypass revision surgery can be just as difficult as recovering from the initial gastric bypass. Recovery time for robotic gastric bypass revision surgery would be the same as that of a laparoscopic revision and may be from one to three weeks depending on how much repair was done.
The gastric bypass revision surgery recovery time inhibits many patients from seeking this option. It is a very stressful ordeal to undergo gastric bypass surgery once, let alone have to endure a second procedure with an additional lengthy recovery.
What is The Shortest Recovery Time For A Gastric Bypass Revision?
There have been many advancements in the field of bariatrics, and today there are non-surgical alternatives that can repair the anatomical changes that can render your previous gastric bypass surgery less effective.
The stomach pouch can be tightened up and the opening from the stomach to the small intestine can be repaired without using any external incisions. For most patients, this cuts down the revision gastric bypass surgery recovery time to less than a week.
How Is A Non-surgical Revision To Gastric Bypass Surgery Done?
A specialist like Dr. Simmons of Simmons Advanced Weight Loss Solutions uses an endoscope to access the patient’s stomach from the inside. The endoscope is carefully placed through the patient’s mouth and then lowered through the throat to the stomach. The stomach is tightened up and the opening at the connection point is made smaller by placing some strategic stitches using a special suturing device. The procedure usually takes less than 45 minutes, has a very low-risk profile, requires no incisions or hospital stay and patients can go home right away. Most patients are back to their usual schedule in just a few days.
When compared to having a second surgery, an endoscopic bariatric surgery revision procedure is a much better option. These new bariatric endoscopic procedures have been a game changer when it comes to helping previous bariatric surgery patients combat weight gain.
What To Do If You Are Gaining Weight After Gastric Bypass
If you are experiencing weight gain after undergoing bariatric surgery, make an appointment with Simmons MD Advanced Weight Loss Solutions. During your consultation, we can discuss your history and determine if you are a candidate for bariatric surgery revision to help stop your weight gain.
We will go over all the options available to you to help you get your weight loss back on track to successfully meet your goals. Experiencing weight gain after a gastric bypass is very common. You are not alone and we can help. Contact us today!