One of the most commonly performed bariatric weight loss surgeries today is the gastric sleeve or vertical sleeve gastrectomy (VSG). Many patients are successful in losing a significant amount of weight in the first year following their surgery, but this is not the case for all patients.
Some patients do not get the results they expected or experience side effects that interfere with their quality of life. Other patients lose a significant amount of weight initially and then gradually gain it back in the years following their gastric sleeve surgery. Can anything be done to help these patients? Is there such a thing as gastric sleeve revision surgery?
Today we are going to talk about what steps these patients can take to regain control of their weight and an option that is available to help them that is much less invasive than gastric sleeve revision surgery.
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How Does Gastric Sleeve Surgery Help With Weight Loss?
Gastric sleeve surgery, or vertical sleeve gastrectomy (VSG), can help patients who have a BMI (body mass index) of 40 or higher lose weight when traditional weight loss methods have failed.
During this surgical procedure, the bariatric surgeon cuts and removes about 75-80% of the patient’s stomach and staples the remaining portion together to form a small tube-like pouch. This makes the stomach capacity much smaller and limits the amount of food the individual can consume at one time.
Additionally, eliminating a large portion of the stomach also eliminates much of the area where most of the hormone ghrelin is produced. This hormone is the one that sends signals to our brain telling us we are hungry, so having it suppressed also helps promote weight loss.
After having gastric sleeve surgery, the patient must spend from 1 to 3 days in the hospital, followed by a four-to-six-week recovery period.
After Gastric Sleeve Surgery
Most patients begin to rapidly lose weight for about 3 months after their gastric sleeve procedure. They should lose about half of their excess weight by 6 months after surgery if they follow their dietary guidelines and get enough physical activity.
Many patients will continue to lose weight and succeed in maintaining that weight, but around 25% of these individuals will begin to gain weight within the first 2 years, and 50% of individuals will experience weight gain in the first 5 years. There are many reasons that cause patients to gain weight after undergoing bariatric surgery.
What Are Some Of The Reasons People Gain Weight After Gastric Sleeve Surgery?
There are several reasons why people fail to meet their weight-loss goals or regain weight after undergoing weight-loss surgery. Research has shown that the most common reasons for insufficient weight loss or weight regain are driven by the patient's lifestyle choices.
- Not Adhering to Dietary Plan - Portion control is the most important factor in achieving the most effective weight loss results following gastric sleeve surgery. Patients may continuously overeat, which can stretch out and enlarge the stomach, if they are not mindful of how much they are eating or if they drink liquids too soon after eating. The patient will be able to eat more food at each sitting as their stomach stretches out, which will lead to weight gain and further stomach stretching. This spirals out of control until the stomach can handle bigger meals, which leads to steadily increasing weight gain. The stomach can expand so much that it almost goes back to its previous size.
- Not Getting Enough Exercise - Physical exercise ranks second to portion moderation as a crucial component of weight loss and maintenance. Gastric sleeve surgery is a tool to assist people in losing weight, but for it to be effective, the patient must be actively involved.
- Failure to Make Use of Support Systems - The origins of obesity are numerous and frequently complex. Researchers who have investigated obesity have connected factors including metabolism, genetics, stress, hormone issues, menopause, psychological factors, and neurological factors as underlying contributors to the disease. Given that the majority of people who have gastric sleeve surgery are unable to maintain a healthy weight on their own, it stands to reason that they will not be able to successfully lose weight and keep it off in the absence of a support system.
- Participating in various support groups is crucial after having any kind of bariatric surgery. The patient should seek psychological support as well as encouragement from loved ones, friends, and those who have undergone the same procedure. Bariatric surgeons have one objective in mind: to assist their patients in losing weight so that they can become healthy people. Many surgeons require their patients to participate in ongoing support as part of their surgical qualification. In addition to the team at your doctor's office, details about local groups that can support you in your weight loss efforts can be obtained from your doctor.
What Can You Do If You Regain Weight After Gastric Sleeve Surgery?
If a patient begins to experience weight gain, they have a few options that can be used to stop it and get them back on track. There is a non-surgical option, or they may choose to undergo revision surgery for the gastric sleeve (VSG revision).
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What Is A Gastric Sleeve Revision?
When a surgeon alters the results of the original procedure for any reason, it is called a revision of the gastric sleeve or a VSG revision. The correction may be necessary for a few different reasons, including:
1. Insufficient Weight Loss
The most likely reason for choosing to undergo a gastric sleeve revision is that the patient did not lose the desired amount of weight within the predicted time frame. Sometimes, this occurs because not enough of the stomach was removed during the initial procedure.
2. Gaining Weight
Weight gain following gastric sleeve surgery is another circumstance in which a revision might be done. Between two and five years after undergoing gastric sleeve surgery, about one-third of all patients do experience weight gain.
3. Adverse Side Effects
Gastric sleeve surgery can occasionally (2%) result in long-term adverse effects such as acid reflux or hiatal hernia. It is sometimes possible to control these side effects with dietary modifications or medication, but in rare instances, a revision may be necessary to address the symptoms.
Signs That You Need A Gastric Sleeve Revision
Gastric sleeve surgery is a tool to help a patient achieve their weight loss goals; it is not in and of itself a weight loss plan. Success comes from making substantial lifestyle modifications and faithfully adhering to them. You should speak to your doctor about a revision of the gastric sleeve if you are experiencing any of the following:
- Not shedding weight as anticipated - It's common to put on a few pounds after surgery; this is known as "rebound weight" and typically results from poor lifestyle decisions. If your diet and exercise routine have been strictly followed but you are still not seeing the results you want, it's possible that you are experiencing gastric sleeve surgery-related issues.
- Putting on weight - After initially losing weight as expected, it may return indicating that the stomach has expanded and needs to be reduced once more.
- Chronic acid reflux -is an unpleasant side effect that affects a small number of patients and is sometimes resistant to medication or dietary changes. When this occurs, a surgical repair to convert the gastric sleeve to a gastric bypass is often necessary.
- Vomiting/nausea or other complications from surgery
How Is A Revision Of Gastric Sleeve Surgery Done?
The technique used to correct issues such as weight gain or chronic side effects will depend on the underlying cause. In some cases, a different type of bariatric surgery will be necessary, but many times the issue can be corrected without surgery. Your doctor can speak with you about the options that are available to address your unique situation.
Using a procedure called Resculpt, the stomach pouch can be made smaller or restored to the size it was immediately after the original gastric sleeve surgery.
What Is Resculpt?
Instead of undergoing revision surgery for the gastric sleeve, this non-surgical technique is used to tighten up the stomach pouch, making it more restrictive, causing weight regain to stop and the patient to begin losing weight again.
A specialized suturing technique is used during the procedure to adhere the walls of the stomach to one another, further reducing its capacity. The Suture Sculpt endoscopic sleeve gastroplasty procedure for weight loss is done using this same technique.
The surgeon gains access to the patient's stomach using an endoscope, which is a long, hollow tube-like instrument that has a light and a camera. While the patient is under sedation, the endoscope is carefully lowered down the patient's throat, and the procedure is completed from the inside.
A special device is lowered down the endoscope and is used to place several sutures in strategic areas to reduce the stomach's total volume. Since there are no incisions involved, neither the stomach's blood supply nor its nerve supply is affected, and the normal digestive process is not altered. The decreased stomach volume prolongs satiety and causes the patient to feel full faster.
Most patients recover from Resculp in only a few days.
What Is The Weight Loss Potential After A Gastric Sleeve Revision?
Many individuals are seeking answers to the question, “How much weight can you lose with a revision surgery?” The answer to this depends on their current situation and the type of revision they are looking for. People often use the word “surgery” when they are actually referring to a procedure. Some individuals desire to convert their gastric sleeve to gastric bypass, which requires gastric sleeve revision surgery and a bariatric surgeon to complete. If they choose a conversion to a gastric bypass, they can lose between 60% and 65% of their excess body weight.
What we find is that most people do not wish to undergo gastric sleeve revision surgery and would prefer to find another less-invasive way to help them restart their weight loss journey. This is where a non-surgical revision procedure like Suture Resculpt comes in. This is an endoscopic procedure that does not require surgery, has significantly fewer risks, and a much shorter recovery time.
The gastric sleeve revision success rate for each person will be different and will depend on things like the type of revision they had and how well they adhere to their healthier lifestyle choices, including diet and exercise. The Suture Sculpt gastric sleeve revision success rate for most patients is they lose between 50 and 70 pounds for every 100 pounds they are overweight after undergoing a revision to gastric sleeve surgery.
We can assist you if you have had bariatric gastric sleeve surgery and have not been successful in losing the amount of weight you desired, or if you have lost and then regained a significant amount of weight. At Batash Endoscopic Weight Loss Center, we can help you get your weight loss journey back on track.
Contact us today to set up a consultation with one of our weight-loss experts. We would be pleased to discuss the options that are available to you and talk to you about a Resculpt revision to gastric sleeve surgery.
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