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Revision of failed Gastric Sleeve Surgery

Although Vertical Sleeve Gastrectomy (Gastric Sleeve Surgery) is an effective procedure for many patients, some do not lose adequate amount of weight. Therefore revision weight loss surgery may be indicated to acquire additional weight loss. Failure of Gastric Sleeve Surgery may be caused by number of different factors:

  • Stretched stomach may be dealt by re-sleeving, this may be a sufficient revision procedure.
  • Some patients may need consideration of malabsorptive and metabolic aspects to compliment Vertical Sleeve Gastrectomy. Procedures like Duodenal Switch and gastric bypass may be sufficient.

Dr Nagi Safa is highly specialized in the revision surgeries, and have performed hundreds of laparoscopic revisional surgeries. He is one of the pioneers to have converted the gastric band surgery to gastric sleeve surgery, by removing the band and cutting the stomach at the same time. He have published in 2012 with his team in Canada, the largest study in the world about the gastric band removal and sleeve gastrectomy as single procedure (Laparoscopic Sleeve Gastrectomy (LSG)—A Good Bariatric Option for Failed Laparoscopic Adjustable Gastric Banding)

Video of a Gastric Sleeve Surgery Revision in Lebanon

Conversion of a failed gastric sleeve to a gastric bypass.

What are the options?
Most Gastric Sleeve Surgery revision are higher risk procedures as compared to the previously performed first weight loss surgery. Conversion of The Gastric Sleeve Surgery to The Duodenal Switch is actually associated with less risk than performing the Duodenal Switch in a singly, for the first time. This is because Vertical Sleeve Gastrectomy is a part of the Duodenal Switch procedure. While converting to Duodenal Switch from a Gastric Sleeve Surgery, a significant portion of the surgery has already been performed. This results in a shorter surgical procedure than performing a Duodenal Switch procedure all at once.

Stretching of the stomach may results in additional problems apart from inadequate weight loss or weight regain. The newly formed tube of the stomach may stretch in a manner that it is not uniform, resulting in a portion of the stomach tube being larger than other. This can result in the stomach to acquire a shape of an hourglass, where both the upstream as well as the downstream portions of the stomach are large, but they are separated by a narrowed portion of the stomach. Although eating may not increase as a result of this stretched stomach tube, it may produce uncomfortable and/or disordered eating. Depending upon the quantity of food a patient takes at each meal and the symptoms he has, there are a couple of revision procedures that result in food moving more directly through the stomach.