Weight Loss Surgery, Gastric Bypass

Revision Operations

Patients who have gastric bypass or other restriction only weight loss operation occasionally require revision, either for inadequate weight loss or for complications. The incidence of major postoperative complications following revisional bariatric procedures is substantially higher compared to original operations. Early complication rates range from 15% to 50%. The death rate reported after revision operations ranges as high as 10%. Undoing any bariatric operation without conversion to another weight-reduction procedure is invariably associated with the patient's promptly regaining the lost weight.

In revision operation, prior operation is altered to most often a Gastric Bypass operation. Revision operation is considered high risk operation even at the hands of most experienced weight loss surgeon. The main reason that revision surgery is considered high risk has to do with the scar tissue that forms from the original operation. This scar tissue is expected result of any surgical manipulation.

Because of the original manipulation, the stomach pouch is scarred densely to the surrounding organs, such as liver, spleen, pancreas and even the bypassed stomach. In order to "revise" the stomach pouch it is necessary to free up all that scar tissue. It is possible to injure the surrounding organs during this process leading to greater bleeding complications. It is also possible to tear or perforate the pouch which needs revising, adding to difficulty in completing the operation.

Revision operation involves operating on scarred and previously manipulated gastric pouch. Because scar tissue does not heal as reliably as tissue that's never been operated on before, the leak rate from revision surgery is 10 times higher or more, in comparison to the original surgery. Revision operation often results in greater chances of open operation, longer hospital stay, and longer recovery time for the patient. This is why a many surgeons are hesitant to perform revision operations.

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