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Revision Bariatric Surgery

Today, bariatric surgery is a particularly effective and accessible method for the treatment of obesity. If it was not for bariatric surgery, many patients would have had very low survival rate due to the metabilic diseases caused by obesity.

However, occasionally, there can be a gap between what patients are expecting and their outcome. These patients will often visit Dr Hussam as he is an expert at performing complex revision surgeries. Complaints from these patients include lower weight loss than expected, regaining the weight they lost, and experiencing uncomfortable side effects or nutritional issues. These complaints are not necessarily the fault of the initial surgeon, but may be unique to the patient or procedure.

It is important to remember that disappointing or non-durable results do not automatically mean permanent failure of treatment. Treating obesity is like treating any other complex health condition and not all methods work equally well on all patients. Combining and re-doing different surgical procedures provides us the opportunity to overcome the issues.

Common reasons for unsatisfactory surgical outcomes

1. Individual responses

Every patient’s physiological response to surgery is different. Even a technically perfect performed procedure might not give the perfect results. In addition, intolerable side effects may occur such as heartburn after a gastric sleeve operation or hypoglycemic episodes after gastric bypass. In these cases, a revision surgery can usually solve the problem.

In other cases, patients might sabotage their results by not following the doctor’s instruction on the after-care. Lack to report problems past-surgery immediately might also lead to failure.

2. Procedure longevity

Not all bariatric procedures are meant to be permanent and by their very nature, some of them require follow-up procedures down the line. For example, after around 10 years, a gastric band can start to break down and lose its effect, or a gastric tube can eventually stretch leading to a loss in restriction; hence, revision is required.

3. Technical errors

Technical mistakes during an initial surgery might show up a year or two post-surgery when the promising weight ceases and the patient starts gaining weight again. This could be caused, for example, if the gastric sleeve or gastric pouch were too large. A revision surgery can in that case have the appropriate results.

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