Revision Surgery

What is Revision Surgery?

Bariatric surgery is an effective method for tackling obesity and managing weight gain. However, there can be instances where further surgical interventions are necessary following the initial bariatric procedure. These additional surgeries may address complications, side effects, insufficient weight loss, or instances of weight regain post-surgery.

Revision surgery is designed to adjust or rectify a prior bariatric weight loss surgery. This type of surgery is usually considered when the initial operation hasn't yielded the expected weight loss outcomes or when complications necessitate further intervention.

At Hunter Weight Loss, we understand the challenges that can arise post-bariatric surgery and are committed to assisting you in getting back on your desired path. Our specialists are available to discuss the various options at your disposal and to guide you in how we can help you. This may include surgery or medications.

Revisional weight loss surgery is always more complex than the initial surgery. To ensure you get the best result, your surgeon will often arrange more tests before revisional surgery than you may have had before your first surgery. Due to the increased complexity of this type of surgery, additional costs are often required.

Who is a Candidate for Revision Surgery?

Individuals who meet the following criteria may be considered for revision surgery:

• Unmet weight loss goals after the initial surgery.
• Weight regain after surgery.
• Experiencing complications from the initial surgery.
• Persistence of weight-related illnesses.

Benefits of Revision Surgery 

Revision surgery offers several potential benefits for individuals who require further intervention after their initial weight loss procedure. These include:

• Enhanced Weight Loss: Help individuals achieve additional weight loss when their initial procedure is ineffective.
• Improved Health Outcomes: By addressing complications or resolving underlying issues, overall health can be improved, and obesity-related health conditions can be reduced.
• Restoration of Quality of Life: Successful revision surgery can help individuals regain their confidence, mobility, and overall quality of life.
• Correcting Anatomical or Structural Issues: This may be required to address issues developed after the initial procedure.

Types of Revision Surgery

There are various types of revision surgery, depending on one’s specific circumstances and individual needs. Some common types include:

• Conversion Surgery: Involves converting one type of weight loss procedure to another, for example, converting a gastric band to a gastric bypass or converting a gastric sleeve procedure to a SADI-S.
• Revision of previous surgery: If your initial operation was unsuccessful, sometimes fixing an issue, like a stretched-out sleeve or changing limb lengths in a gastric bypass, might be helpful.
• Treatment of complications: This might include converting a sleeve gastrectomy to a Roux-en-Y Gastric bypass in the event of difficulty controlling reflux symptoms.
• Reversal: Rarely do patients request that weight loss procedures be reversed. The most common reversal is the removal of adjustable gastric bands, but other procedures, such as the Roux-en-Y gastric bypass, can also be reversed.

What to Do Before Revision Surgery?

Preparations for surgery will depend on the exact surgery needed. The surgeons at Hunter Weight Loss will always fully investigate any issues and gain all the necessary information to perform a revision procedure. Your surgeon will go over specific instructions, but generally, patients will need to:

• Make sure you have had all the tests and investigations requested by your surgeon
• If suggested, follow your preoperative liver-shrinking diet.
• Avoid eating after midnight the day before surgery.
• Ask a friend or family member to be at the hospital for support and comfort. 
• Understand the instructions and requirements for post-surgery follow-up.

What Happens During Revision Surgery?

The details of revision surgery will depend on the type of procedure being performed and your specific needs. Your bariatric surgeon will explain the surgical process, including anaesthesia, incisions, and specific modifications or corrections. These will help you decide the surgical approach best suited to your circumstances.

Generally, removing lap bands will mean one overnight stay in the hospital. Other revision operations involve an average hospital stay of 1-3 nights. 

What to Expect After Revision Surgery?

Postoperative procedures and instructions will vary depending on the surgery. Most patients must take time off work and prepare for 2-4 weeks of rest from strenuous activities. Some patients may also return to a post-gastric surgery diet of liquid and pureed foods.

Following Band Removal surgery, you will need to:

• Arrange for a week off work
• Follow a gentle diet for the first week

Generally speaking, weight loss may be less extensive after revision surgery than after primary surgical procedures. Your surgeon will discuss the specifics of postoperative care with every patient.

Revision Surgery Care Plan

A comprehensive care plan is essential for a successful recovery and long-term weight loss after revision surgery. Here are key elements that may be included in your care plan:

• Nutritional Guidance: A registered dietitian will provide personalised dietary guidelines, emphasising proper nutrition, portion control, and mindful eating habits. They will work with you to ensure you meet your nutritional needs and support your weight loss goals.
• Regular Follow-up Appointments: You will have scheduled follow-up appointments with your bariatric surgeon and healthcare team to monitor your progress, address any concerns, and adjust your care plan.
• Psychological Support: Emotional support is important during the revision surgery journey. Engaging your friends and family or a psychologist can be very helpful in the recovery process. We suggest some psychologists who are familiar with working with weight loss patients.
• Physical Activity Recommendations: Your healthcare team will provide guidelines for gradually increasing physical activity based on your recovery progress. Regular exercise is crucial for long-term weight maintenance and overall well-being. We can suggest trusted partners in exercise physiology to assist in developing an individualised exercise program.
• Monitoring and Surveillance: Ongoing monitoring of your weight, nutritional status, and overall health is important to identify potential complications or issues and intervene early if necessary.

Revision Surgery Outcomes

The outcomes of revision surgery vary depending on individual circumstances, the type of procedure being performed, and the specific goals of the surgery. Your surgeon will advise you of the outcomes to allow you to make an informed decision. Adherence to the post-operative care plan, commitment to lifestyle changes, and regular follow-up care will significantly impact the long-term success and overall prognosis.

Revision Surgery Risks

As with any surgical procedure, revision surgery carries potential risks and complications. These risks may include infection, bleeding, blood clots, anaesthesia-related complications, leakage at the surgical site, and possible complications specific to the type of revision being performed. Your bariatric surgeon will discuss these risks with you and take precautions to minimise them.