Weight loss surgery sometimes needs to be revised to achieve optimal results or to treat some of the complications. Many people mistakenly believe that weight loss surgery is a “one shot deal” and if it does not work, they “have failed” and nothing else can be done. This is far from the truth!
Obesity is a challenging condition, which is difficult to treat. However, we currently have some very powerful treatments at our disposal. As with any medical or surgical treatment, complications and suboptimal results can arise and therefore additional interventions are sometimes needed.
Below are several common issues with weight loss procedures and interventions that can be done to correct them.
Not feeling full with the Lap Band
Sometimes patients just do not feel full, and weight loss is slow. The most common problem is a band that is not tight enough. The best way to adjust the band is to do it under x-rays which allows a surgeon to see how tight the band actually is.
If the band is adjusted too tightly, the pouch above the band can stretch or the band can slip. This can be easily detected with x-ray. A revision surgery can be performed to place the band back in the correct position.
Constant nausea and difficulty swallowing with the band.
Quite frequently, patients notice that they have increasing trouble swallowing food yet their weight keeps increasing. This condition can be caused by proximal slippage of the band. The band can migrate higher on the stomach and move to the end of the esophagus. This can cause difficulty swallowing and constant nausea. At the same time, patients do not feel satisfied with small portions. In the case of proximal slippage of the band, the band will have to be removed or repositioned lower on the stomach to restore its normal function.
The band is not working
Sometimes, despite all efforts, the band just does not work. The band then can be easily removed and the patient can have a gastric sleeve procedure or gastric bypass.
The conversion process from the band to the sleeve or bypass should be done in two stages. First, the band gets removed, and then after waiting for six to eight weeks a gastric sleeve or bypass can be performed. This waiting period is observed to let the stomach go back to normal after Lap Band removal.
Weight gain after Sleeve
Sometimes part of the sleeve can stretch leading to increased capacity and weight gain. A corrective surgery can be performed to remove the stretched part. This is a straightforward surgery. Interestingly, once the stretched part is removed, the sleeve typically does not stretch again.
Weight gain after bypass
Weight gain after bypass can be caused by stretching of the gastric pouch or stretching of the pouch outlet, called the anastomosis. A revision surgery can be performed to reduce the size of the pouch and promote weight loss again. The anastomosis can be tightened via an endoscopic camera. In some cases, a Lap Band can be placed over the bypass to provide additional restriction.
There are many options for the patients who gain weight after weight loss surgery. A detailed evaluation is necessary to discover the best option for each specific case.
It Takes Commitment to Win the Weight Loss Battle
If you and our surgeon have decided that gastric surgery will be the right procedure to resolve your condition, keep your weight loss expectations and goals realistic. If you were not able to maintain your exercise and portion control plan after a first gastric surgery, a revisional gastric surgery can give you a second chance. But, a second gastric surgery doesn’t make resisting bad habits and temptations any easier. Your New Jersey gastric bypass surgeon and team of weight loss professionals can help guide you through an easy-to-follow plan to help you stay on track, and maintain a healthy weight for the long term.
If you’ve previously had a gastric surgery but have struggled to keep the weight off, please contact one of our New Jersey locations for a revisional gastric surgery consultation.