Gastric Bypass Revision

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Heart And Gastric Bypass Information (SCROLL DOWN FOR GASTRIC BYPASS)

Information On Gastric Bypass Revision

There are three reasons why gastric bypass revision is necessary for people who have undergone gastric bypass surgery: medical complications arising from the gastric bypass surgery, failure to lose enough weight and weight regain. Failure of the initial gastric bypass surgery may also be as a result of the patient following an inappropriate diet that caused complications that could require surgical correction.

Before recommending gastric bypass revision surgery, the doctor must determine whether the gastric bypass failure was caused by the patient’s food consumption. Patients considering this surgery are required to keep track of their food intake by keeping a food diary for a specific period of time to establish how much is consumed.

Once diet has been ruled out as a cause of gastric bypass failure, the doctor will need to determine whether your stomach pouch size and your stoma (the opening between your stomach and the small intestines) has stretched or is too large. A dilated pouch and stretched stoma allow the patient to eat more than is required for the gastric bypass surgery to be successful. To do this he may perform an upper endoscopy or upper gastrointestinal (GI) tract radiography. These two tests can also help detect oesophageal and roux limb abnormalities as well as staple line problems and gastro-gastric fistula.

There are several types of gastric bypass revision surgeries that a doctor may choose to correct the failure.

StomaphyX Procedure - This is a common form of gastric bypass revision procedure which involves the insertion of an endoscope through the mouth and into the stomach pouch under general anaesthesia so as to suction parts of the stomach tissue and create tissue folds effectively reducing the size of the stomach. This procedure is only used to reduce pouch and not stoma size.

Transoral ROSE (Restorative Obesity Surgery, Endolumenal) - The ROSE procedure is similar to the StomaphyX as it also involves inserting endoscopes into the mouth, down the esophagus and into the stomach pouch. Parts of the stomach tissue are gathered together creating a pleat between the stomach and the small intestine that is sutured together reducing the volume of the stomach and or the size of the stoma.

Lap Band Surgery - This gastric bypass revision procedure involves wrapping and sewing into place a silicone and silastic band round the top of the stomach. This is a restrictive procedure as it works by making the stomach smaller hence making the patient feel fuller sooner.

Lengthening the Roux Limb - Due to the high risk, as compared to other gastric bypass revision procedures; this is not a standard method of correcting failed bypass surgery. It is usually only considered when the patient has a low metabolic rate with poor weight loss results even with an exercise regime.

Conversion to Duodenal Switch - This procedure is considered the most difficult of the gastric bypass revision procedures but is known to have the best results. It is usually performed laproscopically but in some cases it is done as an open surgery.

In comparison to the primary bypass surgery the occurrence of complications following revision procedures is significantly higher. For this reason the patient should follow all instructions and diets religiously after the first surgery to lower the chance of needing a gastric bypass revision.

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