Vertical sleeve gastrectomy (VSG) more commonly known as gastric sleeve surgery is one of the most frequently performed weight loss surgeries. Many patients lose a significant amount of weight in the months that follow their surgery and are successful in maintaining that weight loss. But for a good many patients, their weight loss is only temporary.
A recently published study looked at data from approximately 225,000 patients who underwent gastric sleeve surgery. Many individuals sought a revision of gastric sleeve surgery at some point during the following 10 years. At the 5-year mark, approximately 8% of the patients sought revision, after 7 years about 8%, and after 10 years around 12%.
Sometimes individuals do not attain the weight loss results they anticipated or they end up with adverse side effects that can not be controlled with medication. Other individuals may experience substantial weight loss initially and then gain back all the weight they lost (or even more) within a few years of having their gastric sleeve surgery.
Today, we are going to answer the question, “What is a gastric sleeve revision?”. We will discuss how it can help the patient resume weight loss, and what options are available to patients for the revision of gastric sleeve surgery.
What Is The Gastric Sleeve Surgery Procedure?
To understand how a revision of gastric sleeve surgery would be done, let’s go over what gastric sleeve surgery entails and how it works for weight loss.
Gastric sleeve surgery is usually performed on individuals who have tried traditional weight loss methods and failed. They have a body mass index (BMI) of at least 40 or a BMI of 35 or higher and also have one or more obesity-related health conditions such as high blood pressure or type 2 diabetes.
During VSG surgery, the surgeon permanently eliminates around 75% of the individual’s stomach and staples the remaining edges together to form a smaller banana-shaped pouch. The patient is unable to eat as much going forward because of the reduced stomach capacity.
Removing a large portion of the stomach also eliminates the part of the stomach that produces the hormone that causes us to feel hungry. With the major source of ghrelin diminished, the patient is not subjected to continual hunger pangs while they try to follow their weight loss plan.
Patients normally spend a day or two in the hospital after undergoing gastric sleeve surgery and then another four to six weeks recovering.
Immediately After Gastric Sleeve Surgery
Many individuals lose a great deal of weight in the first three months after surgery, and if they are following their weight loss plan, by the time they reach the six-month mark, they will have shed about 50% of their excess body weight.
Excess body weight is calculated by taking the patient’s current weight and subtracting their ideal weight (the healthy weight they should be). For example, if an individual weighs 250 pounds and their healthy or “ideal” weight is 150 pounds, then their excess weight is 100 pounds. (250 minus 150 = 100) Using this example, the patient would have lost about 50 pounds at the six-month mark after gastric sleeve surgery.
The more weight an individual has to lose, the more pounds they normally drop during these initial six months. Patients must follow a strict diet while their stomach heals after having gastric sleeve surgery, which includes several weeks of liquids, followed by purees, and gradually working up to solids. The smaller stomach capacity, coupled with the time needed for the stomach to heal and the strict diet that is necessary, can be credited for the dramatic weight loss results during the first 3 months.
Studies have shown that almost half of the patients who have gastric sleeve surgery will regain weight within 2 years after their surgery. The individuals who were considered super obese had the highest rate of failure. Since obesity is a complex disease, there can be many different factors that play into an individual’s ability to lose weight and keep it off long-term.
Why Would Someone Need Revision Surgery After A Gastric Sleeve?
Individuals may fail to lose the weight that they expected, or they may experience weight regain after they have lost a substantial amount of weight following gastric sleeve surgery. The most typical reason patients experience either of these situations is a result of their failure to follow their weight loss plan.
Patients who continue to live unhealthy lifestyles will either regain all of the weight they have lost or fail to lose the amount of weight they desire.
Failure To Stick To Healthy Eating Habits
One of the most important factors that will play a large role in how much weight or how fast a patient will lose weight after gastric sleeve surgery is how well the patient follows their dietary guidelines. Patients must limit their portions and make a conscious effort to choose and eat a healthy, low-calorie diet.
The guidelines provided by weight loss experts are designed so patients can get the most out of their weight loss surgery. Being mindful of when and how much liquid they consume between meals and practicing ongoing portion control will help keep their stomach from stretching out.
Overeating continually or drinking liquid with meals can cause the stomach to stretch out gradually, allowing the patient to eat more than they should. Over time, the stomach can stretch out to the size it was before the gastric sleeve surgery, which will result in weight gain.
Failing To Engage In Adequate Physical Activity
Second, following their dietary guidelines, getting enough exercise can directly impact a patient’s weight loss results. Any type of bariatric surgery, including the gastric sleeve, is intended to be used as a tool to help patients lose weight. To be successful in losing weight and maintaining that weight loss, the patient must actively participate in physical activity.
Underutilization Of Support Offered
Obesity is a symptom of many underlying conditions, and often individuals require expert assistance to identify and treat these issues that are impeding their ability to lose weight. Some of the underlying issues that can inhibit weight loss or contribute to weight gain are:
- Hormone issues
- Psychological factors
- Neurological factors
Individuals who have undergone gastric sleeve surgery have been unable to lose weight and keep it off on their own. The surgery will help them with some of the issues that contributed to their weight-related issues, but they will need a substantial support system for them to succeed in reaching their weight loss goals.
Studies that were conducted have proven that ongoing support helps patients stay motivated and provides a resource for accountability, and these outside influences can help teach patients helpful coping skills. This support system may include:
- Your doctor’s recommended team of professionals.
- Social support
- Weight loss programs (in person or online)
- The Obesity Action Coalition
- Weight loss apps and fitness trackers
- An online community consisting of other gastric sleeve patients
Because having ongoing support is so crucial to their patient’s results, many weight loss doctors require their patients to commit to participating in a supervised weight loss program that includes their active involvement in support systems before they will perform their weight loss procedure.
When Would A Patient Need A Revision Of Gastric Sleeve Surgery?
A patient has a few alternatives available to them to help stop weight gain and get them back on track if they have chronic adverse side effects. They can have a non-surgical revision of the gastric sleeve or elect to have gastric sleeve revision surgery. Either procedure would be done to correct one of the following:
Inadequate Loss of Weight
Most individuals undergo a revision of gastric sleeve surgery to address underwhelming weight loss results. In some cases, the initial procedure did not reduce the stomach capacity enough to be effective for the patient.
The Patient Is No Longer Losing Weight And Is Gaining Weight
Almost 50% of gastric sleeve patients gain weight within the first 24 months following gastric sleeve surgery. This can result from many factors, but the most common is that the smaller stomach that was created during the initial surgery has become stretched out and is no longer providing the restrictive environment that was aiding in their weight loss.
The Patient Is Experiencing Chronic Side Effects
Almost 2% of the patients who undergo gastric sleeve surgery experience long-term side effects, which include hiatal hernia or severe acid reflux that cannot be controlled through modifications in their diet or medication. To correct these issues, revision surgery from a gastric sleeve to a gastric bypass may be required.
You May Need A Revision Of Gastric Sleeve Surgery If:
- You are not losing the amount of weight you desire.
- You are gaining weight or your weight loss has plateaued.
- You are experiencing ongoing, severe acid reflux that is unresponsive to medication.
- You are vomiting or are experiencing nausea or other chronic side effects that were triggered by the gastric sleeve surgery.
It is normal to gain a small amount of weight after undergoing gastric sleeve surgery, but if you begin to gain in excess, it is time to contact your doctor and discuss treatments to stop the weight gain.
The surgery is a tool meant to be used in conjunction with patient efforts to help them reach their weight loss goals. The tool will not do all the work by itself and will require the patient to work hard and make substantial lifestyle changes to effectively lose weight and maintain the loss.
What Is A Gastric Sleeve Revision?
A revision to a previous gastric sleeve surgery is performed to correct a stomach that has been stretched out. This can happen as a result of eating too quickly or overeating regularly. When you overeat, the stomach stretches a little, which then allows it to hold larger portions of food and require more food for satiety. This becomes a vicious cycle as the patient progressively begins to ingest more and more calories, which leads to weight gain.
The stomach needs to be reduced again to provide the restrictive capabilities and promote future weight loss. This can be accomplished through an endoscopic procedure at the Simmons MD Advanced Weight Loss Solutions in Miami, Florida.
How Is A Gastric Sleeve Revision Done?
A revision to gastric sleeve surgery may be done differently depending on the underlying reason the revision is needed. In some cases, a non-surgical revision of bariatric surgery can be completed to correct these issues, and in other cases, another surgery may be necessary. The best way to determine what options you have available to you is through a consultation with a qualified obesity expert.
A non-surgical endoscopic procedure is the least invasive method to perform a revision of gastric sleeve surgery. At Simmons MD Weight Loss Solutions, we offer revision of gastric sleeve surgery without the use of incisions.
How Is An Endoscopic Gastric Sleeve Revision Done?
An endoscopic procedure is a non-surgical method used to tighten up the stomach pouch, making it more restrictive, causing weight gain to cease and the patient to start losing weight again, rather than undergoing revision surgery for the gastric sleeve.
An endoscope is a thin, hollow instrument with both a light and a camera that enables the surgeon to access the patient’s stomach. The endoscope is carefully lowered down the patient’s throat while they are sedated, and the procedure is performed from the inside in the same manner as the endoscopic sleeve gastroplasty procedure.
The hollow endoscope also allows other necessary tools access to the procedure site. The surgeon manipulates the patient’s stomach into a smaller banana-shaped sleeve and then uses a special suturing device lowered down the endoscope to place several strategically targeted stitches in the stomach to hold it in place.
The surgeon does not use any incisions; therefore, neither the nerves nor the blood supply to the stomach are altered. The restoration of the reduced stomach capacity helps the patient with portion control and prolongs satiety, which will promote weight loss.
The non-surgical gastric sleeve revision is done as an outpatient procedure and does not require a hospital stay. Most patients experience a very short recovery from an endoscopic gastric sleeve revision.
How Much Weight Can Be Lost After A Gastric Sleeve Revision?
The amount of weight that a patient can lose after undergoing an endoscopic gastric sleeve revision is going to be different for each patient. Their results are influenced by the type of revision performed and their dedication to adhering to healthy dietary choices and ongoing physical activity over the long term. Many patients have reported weight loss of 50 to 70 pounds following revision of gastric sleeve surgery.
If you have previously had gastric sleeve surgery and did not lose the amount of weight you expected or if you have experienced a significant amount of weight regain, we can help! Contact Simmons MD Advanced Weight Loss Solutions and set up a consultation to discuss gastric sleeve revision options to help you get your weight loss back on track.
At Simmons MD Advanced Weight Loss Solutions, our team of experts can help pinpoint underlying causes that are inhibiting weight loss and create a customized plan to address them. Set up an appointment with one of our knowledgeable professionals today and get the help you deserve