A common scenario: 39-year-old woman is obese. She had gastric sleeve surgery about three years ago. She has regained most of her weight from before surgery. She no longer feels full and all her hunger cravings have returned. What to do?
This is a problem that our clinic sees a lot. Everyone regains weight over time after gastric sleeve surgery. Some regain a little. Some a lot.
Firstly, we must address the diet and exercise. Is the person eating more than 1200 calories a day? Usually this is the main problem.
Secondly how big is the stomach now. Has the stomach stretched back to normal size. We can investigate this by means of barium meal xray and a gastroscopy.
If the stomach has stretched, the patient may be suitable for re-sleeving. This is done in a similar fashion to the original gastric sleeve. Reflux may be worsened and there is a higher gastric staple line leak rate from revisional surgery.
If the stomach has not stretched , then revisional surgery will mean a gastric bypass. This is not a friendly operation to live and can carry permanent short and long term effects. Many patients will need further operations.
Before committing to revisional surgery, it is best to talk to an experienced bariatric surgeon about all the risks and side effects. Again, even with further surgery, weight may not stay off if a strict diet and exercise program is not adhered to.