Revisions of previous failed or inadequate weight loss procedures are complex procedures often with a higher complication rate and lower weight loss results compared with the same procedure performed for the first time.
Several revision procedures can be performed using the laparoscopic approach.
Reasons for revision include:
Technical failure of the procedure
Complications related to procedure
Inadequate weight loss
Common revisions are as follows.
| VBG (stomach stapling) |
Gastric bypass |
| VBG |
Duodenal Switch |
| Lapband |
Lapband (for slip or erosion) |
| Lapband |
Gastric bypass |
| Lapband |
Duodenal Switch |
| Gastric bypass |
Gastric bypass (for complications) |
| Gastric bypass |
Duodenal switch (rarely performed) |
Having an accurate idea of existing anatomy and the roadmap to conversion to a desired procedure is key for a successful revision and keeping the complication rates low. A decision to perform a revision should not be undertaken lightly. In our practice, our surgeon performs all the tests required before the decision such as an upper GI study, endoscopy, review of old operative records etc on his own in order to get as much information as possible.
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