After primary (first time) bariatric surgery further operations (revisional surgery) may be considered due to long term weight regain or as corrective surgery to address a complication.
For Weight Regain
The most common reason for RBS is weight regain after a previous operation (or lack of adequate weight loss from the first operation). This highlights the chronic and relapsing nature of the causes of obesity. There is some degree of individual variability of the results after bariatric surgery.
In the long term some weight regain is almost universal with every bariatric operation. When the weight regain exceeds a certain limit it is considered as failure of the procedure.
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Further Information
Studies have demonstrated that RBS in general leads to less maximum weight loss compared to the results of the same operation in the primary setting and carries a higher rate of complications. Due to these reasons goals of further surgery must be carefully considered as a part of life time health and weight management strategy. Any potential benefit must be weighed against the risks of further surgery.
Before considering further surgery it is important to have an honest reflection as to the reasons for failure of previous surgery and be prepared to correct patient related factors if any. You must satisfy yourself of having determination and a mindset to comply with the after surgery requirements of further surgery.
Some of the common mid to long term complications which requires corrective surgery are:
- Gastric band – reflux, regurgitation, aspiration, food intolerance, blockages, erosion.
- Gastric sleeve – reflux, regurgitation, aspiration, obstruction.
- Gastric bypass – peptic ulcer that may lead to perforation or bleeding, postprandial hypoglycaemia, internal hernia, bile reflux, diarrhoea, dumping.
