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Revision Sleeve Gastrectomy
Revision sleeve gastrectomy is a bariatric surgery performed on patients who have previously undergone sleeve gastrectomy but did not achieve the expected weight loss or experienced weight regain over time. While the original sleeve gastrectomy is highly effective, some patients may struggle with long-term results due to stomach enlargement, lifestyle changes, or metabolic adaptation.
The revision procedure is designed to correct these issues by resizing the stomach, addressing complications, or converting the surgery into a more suitable bariatric option. It provides patients with another opportunity to achieve their weight loss goals and improve obesity-related health problems such as type 2 diabetes, high blood pressure, and sleep apnea.
At MDO Health Tourism, revision sleeve gastrectomy is performed in internationally accredited hospitals in Türkiye by experienced bariatric surgeons, ensuring patient safety and optimal outcomes.
Why Is Revision Sleeve Gastrectomy Performed?
Although sleeve gastrectomy is one of the most common and successful weight-loss surgeries worldwide, not all patients achieve lasting results. There are several reasons why a revision might be necessary:
- Weight Regain: Over time, the stomach pouch may stretch, allowing patients to eat larger portions again, leading to weight regain.
- Insufficient Weight Loss: Some patients may not lose enough weight after the initial procedure, especially if they had a very high BMI before surgery.
- Medical Complications: Conditions such as severe acid reflux (GERD), staple line problems, or intolerance to the sleeve may require surgical correction.
- Metabolic Factors: The body adapts to reduced calorie intake, slowing metabolism and limiting weight loss despite adherence to dietary guidelines.
Revision sleeve gastrectomy addresses these issues by reducing stomach size further, reshaping the stomach, or converting the sleeve into a different bariatric procedure, such as a gastric bypass.
How Is Revision Sleeve Gastrectomy Performed?
Revision sleeve gastrectomy is performed laparoscopically, using minimally invasive techniques that involve small abdominal incisions and specialized surgical instruments. The specific approach depends on the patient’s condition and the reason for revision.
Resleeve Gastrectomy: If the stomach has stretched, the surgeon may remove additional portions to restore its narrow tube-like shape.
Conversion to Gastric Bypass: For patients suffering from severe reflux or inadequate weight loss, the sleeve may be converted into a Roux-en-Y gastric bypass. This reduces stomach size and bypasses part of the small intestine to limit calorie absorption.
Other Revisions: In rare cases, surgeons may recommend a duodenal switch or other advanced bariatric techniques for patients with severe obesity.
The surgery is carried out under general anesthesia and usually takes 2–3 hours. Patients are typically encouraged to walk within a few hours post-surgery and remain in the hospital for 2–3 days for monitoring.
Recovery After Revision Sleeve Gastrectomy
Recovery after revision surgery may take slightly longer compared to a primary sleeve gastrectomy due to the complexity of the procedure. However, since it is performed laparoscopically, patients generally experience less pain, faster healing, and a lower risk of infection compared to open surgery.
Most patients return to light activities within 2–3 weeks, while complete recovery may take 4–6 weeks. Just like the first sleeve surgery, patients follow a structured diet plan that starts with liquids, then pureed foods, and gradually transitions to soft and solid foods.
Regular follow-up appointments with surgeons and dietitians are crucial. These visits help track progress, adjust nutritional plans, and prevent complications. Patients often achieve significant weight loss again within 12–18 months after revision.
Things to Consider Before and After Revision Surgery
Revision sleeve gastrectomy is more complex than the initial procedure, which means careful patient evaluation is essential. Before surgery, patients undergo a full medical assessment, including imaging tests, blood work, and consultations with dietitians and psychologists. This ensures the revision is safe and tailored to individual needs.
After surgery, patients must commit to strict lifestyle changes. This includes adopting healthy eating habits, engaging in regular physical activity, and attending follow-up medical visits. Nutritional supplements may also be necessary to avoid deficiencies, especially if the revision involves an intestinal bypass.
Patients should also understand that revision surgery is not a substitute for lifestyle changes. Success depends on long-term commitment to healthy choices in addition to the surgical intervention.
Risks of Revision Sleeve Gastrectomy
While revision sleeve gastrectomy is generally safe, it carries a slightly higher risk compared to the first surgery due to scar tissue and anatomical changes from the previous operation.
Possible risks include infection, bleeding, leakage from the staple line, and nutritional deficiencies. Long-term risks may include acid reflux, bowel obstruction, or insufficient weight loss if lifestyle changes are not maintained.
Choosing an experienced surgical team and following medical guidance closely helps minimize these risks and ensures successful results.
Benefits of Revision Sleeve Gastrectomy
Despite the challenges, revision sleeve gastrectomy offers significant benefits for patients who are struggling after their first surgery:
- Renewed and sustainable weight loss.
- Improvement or resolution of obesity-related health conditions such as diabetes, hypertension, and high cholesterol.
- Relief from complications such as severe reflux.
- Enhanced quality of life and improved mobility.
- A second chance at achieving long-term health goals.