Revisional Bariatric Surgery in Tijuana, Mexico

INTRODUCTION

Has Your Weight Loss Surgery Failed?

If you've had bariatric surgery and have noticed a significant weight regain, you're not alone. Bariatric surgery, despite its high success rate in the first year, can sometimes fail to provide the results that patients want in the long term. The reasons for this are varied, but bariatric revision surgery is typically effective in making sure that patients lose weight and keep it off. If you're looking for revision surgery for weight loss in Mexico, schedule an appointment with Dr. Ramos Kelly today!

What Is Bariatric Revision Surgery?

Revision bariatric surgery – sometimes known as revisional surgery or bariatric revision surgery – refers to a procedure that follows a previous bariatric surgery that did not provide the desired long-term results. An example is a patient who loses 100 pounds in their first year, but after another year gains 50 pounds back. Revision surgery can fix this.

FAQ

FAQ about Revision Surgery in Mexico

A previous weight loss surgery that did not lead to the desired level of success.

Many factors influence post-op weight loss. One major factor is the surgery itself. The surgeon may not have performed the surgery in a way that provides optimal weight loss. Here’s an example: some surgeons create larger stomach pouches for their gastric bypass patients, which allows their patients to eat more food, consume more calories, and regain more weight.

Another major factor is post-operative care. If a patient is not given proper instructions on how to eat, exercise, and hydrate, they might not be able to sustain weight loss over the long term. Long-term behavioral changes are necessary for weight loss to persist, even with the aid of bariatric surgery.

Revision surgery is needed when patients did not lose the weight that they wanted, when patients experience complications, or when patients experience a relapse of their obesity-related conditions like type 2 diabetes. Because bariatric surgery aims to provide long-term weight loss, revision surgery is needed when this goal is not met.

We recommend revisional bariatric surgery for patients who did not experience adequate weight loss after 2 years of getting bariatric surgery, patients who experienced significant weight regain after hitting a weight loss plateau, and patients who experienced a relapse of obesity-related conditions. We also recommend revision surgery for patients who had complications after getting bariatric surgery.

Many bariatric procedures have long learning curves, and inexperienced surgeons may perform procedures that don’t provide optimal results. Dr. Ramos Kelly has performed thousands of bariatric procedures over his career and has seen the positive effects that revision surgery can have on patients.

The decision to get bariatric revision surgery must not be taken lightly. Depending on your original procedure, different types of revision surgery may be recommended. For example, gastric sleeve to duodenal switch is sometimes performed for patients who don’t get much weight loss from gastric sleeve surgery and are unable to lose weight with behavioral modifications alone. Gastric bypass patients may have their stomach pouch revised to further restrict the amount of food they can eat. Dr. Ramos Kelly is uniquely qualified to make these recommendations for you.

Before you consider getting revision surgery, first you must ask yourself whether you’re a good candidate. Good candidates for revision surgery:

  • Lost less than 50% of their excess weight after gastric sleeve or gastric bypass procedures;
  • Regained a significant amount of excess weight after a weight loss plateau;
  • Have seen a recurrence in obesity-related conditions such as type 2 diabetes or high blood pressure, even after these conditions went into remission;
  • Are experiencing complications or serious side effects long after the surgery took place as determined by a surgeon

 

All surgeries have a risk of complications, and bariatric revision surgery is no different. Some bariatric surgery patients experience complications such as gastric bleeding, staple line leaks, infections, and blood clots. Talk to Dr. Ramos Kelly about your concerns regarding surgical complications.

FAQ

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A “learning curve” exists for most operations and bariatric surgery has one of the longest. This is especially true when we consider the Laparoscopic Gastric Bypass. It is often helpful to know at what stage your surgeon was in their career when you were treated. For example, the success of gastric bypass surgery is largely dependent upon the size of the gastric pouch. This part of the surgery is technically challenging and often requires the surgeon to have performed many operations before mastering it. As a result, a surgeon may have made very large gastric pouches early in their career. Furthermore, some surgeons continue to make large pouches despite our current understanding that pouch size and weight loss are more directly related.

Oftentimes, the postoperative instructions given to patients are incorrect or lacking. Therefore, the patient did not know the best way to use their new “tool”. Even though the patient may be out of the “golden period” for rapid weight loss, they usually benefit considerably from proper instruction and can therefore avoid revisional bariatric surgery.

Weight loss history following the initial surgery tells us if the operation was ever effective or if it “failed the patient” from the very beginning. If postoperative weight loss never occurred or was minimal, then it is likely that there was a technical problem with the operation, and gastric bypass revision may be able to correct the problem at the root.

Likewise, complications occurring after the surgery may have led to technical problems that have influenced the durability of the weight loss. Such complications may include intraabdominal infections, ulcerations, band infections, and prolonged vomiting postoperatively.

Considering bariatric surgery as a “tool” to be used for long-term weight loss, we must determine if the patient has used their “tool” ineffectively or if the patient’s “tool” does not work. If the “tool” has not been used effectively then it is unlikely that a gastric bypass revision would be beneficial. However, if the “tool” is broken or never worked, then a revision may be beneficial.

For example, if the pouch of a gastric bypass was made too large then the patient may lose weight for the first year but eventually lose their sense of satiety or restriction and gain weight. Usually, an upper GI x-ray series will help us determine the pouch size, and an option such as lap band after gastric bypass may prove beneficial.

If a patient had gastric banding, they may never feel “satisfied” with small meals. Commonly, gastric banding does not give patients the same feedback of satiety that the gastric bypass provides. In such cases, a gastric bypass revision may benefit the patient. However, taking down the scar around the band can be technically difficult.

If a patient had a vertical banded gastroplasty (VBG)/ stomach stapling, they may have initially lost weight only to lose their feeling of restriction and regain the weight. Several technical failures arise with this type of surgery over time. It is appropriate to consider gastric bypass revision if one of these failures has occurred.

Remember that gastric bypass revision operations are more technically challenging and carry a higher complication risk. Patients need to seek out very experienced bariatric surgeons that perform revisional bariatric surgery procedures. Not everyone who regains weight or fails to lose as much weight as they would have liked are candidates for revisional bariatric surgery. Because morbid obesity is a multi-factorial disease, a multi-disciplined approach should be utilized to treat patients that have regained or failed to lose weight.

Successful bariatric surgery starts with the operation. Some operations have been done much longer and have been proven to be more durable over time. Gastric bypass surgery is one such operation. Postoperative instruction and support are also very important. Snacking behavior, poor water intake, lack of exercise, and poor supplementation intake can all lead to poor outcomes.

When patients are being evaluated for a gastric bypass revision in our program, a consultation with the surgeon is scheduled. At that time all tests are reviewed as well as the operative report if provided. Our surgeon then assesses the risks and potential benefits of gastric bypass revision surgery for the patient. If surgery is indicated and the potential risks are understood, our program can provide years of experience in revisional bariatric surgery to help you achieve your goal.