Revisional surgery can address complications, insufficient weight loss, weight recurrence or nutritional problems. Endoscopy, imaging and prior operative reports help establish the anatomy and what a revision could accomplish. Risks and expected benefits differ from those of a first operation.
Revisions performed here
- Full conversion of gastric bypass to BPD-DS
Reconstructing the stomach and intestinal route to a sleeve-based duodenal switch is a major revision. Feasibility depends on the existing anatomy, tissue condition and nutritional reserve.
- Physiologic conversion of gastric bypass to BPD
Altering intestinal routing to create a biliopancreatic-diversion effect differs from a full conversion to sleeve-based DS. Existing limb lengths and remaining absorptive bowel are central to planning.
- Band over bypass
Adding restriction to a bypass pouch may have a selected role, but requires assessment of why the first operation is no longer meeting its goals and discussion of band-related risks.
- Fobi pouch revisions
The pouch, outlet and existing ring or band are assessed for restriction, intolerance, erosion or other anatomic problems.
- Band removal
Removal may address intolerance, slippage, erosion or other problems. Whether to convert to another operation at the same time is a separate decision.
- DS reversal (formal and/or physiologic)
Restoring continuity or changing limb lengths may reduce malabsorption when nutritional complications warrant it. The expected metabolic and weight effects are also discussed.
- SADI conversion to true DS
Conversion from a single-anastomosis arrangement to a two-anastomosis DS changes the intestinal reconstruction; it is not simply a terminology change.
- OAGB conversions
Symptoms, bile reflux, nutritional problems or weight-related goals may prompt evaluation of conversion from one-anastomosis bypass.
- Surgery for unexplained chronic pain after bariatric surgery
Persistent pain requires a careful work-up for anatomic and nonoperative causes. Exploration is considered selectively; pain relief cannot be promised when no correctable cause is established.
Also used when they fit
- OAGB
- SADI
- Endoscopic therapies
- Adjustable gastric band — mainly existing bands, fills, slips, and selected new indications
- Metabolic omentectomy: evidence and limitations
Bring records. If you do not have them, we still start with what can be seen now.