Revisions can provide new hope in wellness journey

In life, second chances don’t come along very often. When they do, you need to jump at them and take advantage of the opportunity.  To be a candidate for a bariatric surgery revision should be viewed as a second chance to return to a healthier, more active way of life.  But how does one know if they are a candidate for a revision?

Dr. Justin Braverman

Have you regained some of the weight you initially lost after surgery?  Did you not lose as much weight as expected?  Are you struggling to maintain your current weight?  Can you eat larger portions and eat much faster?  If you answered yes to any of these questions, you may be a candidate for a revisional bariatric procedure.

There are many possible causes of weight regain after successful weight loss surgery.  Obviously, proper eating and exercise habits are paramount to success, but sometimes there is an anatomic cause for the weight regain.  Although these problems only rarely happen, changes to your surgical anatomy can derail your success.  The good news is that there are a multitude of options to treat these issues, and our staff at The N.E.W. Program will work to help you develop the proper eating and exercise patterns that will lead to long-term success.

The three most common bariatric operations (Band, Bypass, and Sleeve) all cause weight loss by essentially the same mechanism, helping a patient eat slowly and feel full with a smaller portion.  Although it is a powerful procedure, the Band has the most variable amount of weight loss success of the three operations.  There is a small minority of band patients who do not achieve their desired results, and their weight may hit a plateau higher than their goal. 

If this describes your situation – Do Not Fret!  There are options and you can convert to a gastric bypass or gastric sleeve.  The surgeons at The N.E.W. Program have performed many band-to-bypass or band-to-sleeve operations.  In expert hands these are safe operations with outstanding results.  Converting to another type of procedure can give you the jump start you need to get back on track and lose the rest of your excess weight.  As an added benefit, changing to a gastric bypass will help treat the metabolic diseases associated with excess weight, like diabetes and high cholesterol, which perhaps were not controlled by the band.

After gastric bypass or sleeve gastrectomy, although rare, some patients can experience dilation, or stretching of the small pouch.  If this has happened, portion size gets larger, you can eat faster, and appetite returns too quickly after a meal.  To determine if this is a possible cause of weight regain, an outpatient endoscopy is performed.  This is a painless, 10-minute procedure where a small camera is placed through the mouth and the size of the stomach is measured.  

If the pouch is too big, we can fix it.  There is a variety of surgical options that can repair the anatomy, restoring the feeling of restriction to give you the leverage you need to refocus your lifestyle and better manage your weight.

Traditionally, the primary way to restore the size of a dilated stomach pouch was to operate and surgically “cut and sew” the pouch back to its original size.  Often times covered by insurance, this technique is still frequently used.  It is a safe and effective way to fix dilations, and weight loss with this option can be significant. 

Today we have even safer and less invasive procedures.  An adjustable band can be placed over a previous bypass or sleeve.  During this procedure there is no cutting of the stomach or intestines.  Since the band is adjustable, it can be tightened over time, putting the patient in control of portion size and appetite in order to help lose the regained weight. 

The N.E.W. Program is also proud to offer the ROSE procedure.  This is latest technique in minimally invasive surgery, and truly at the forefront of the field of bariatrics.  In fact, the surgeons at The N.E.W. Program were one of the first to perform the ROSE procedure in the U.S.  The technique is termed “Natural Orifice Surgery” because the entire procedure is performed through the mouth with no incisions.  The ROSE device allows the surgeon to place stitches on the inside of the stomach to reduce the size of the pouch.  Patients wake up from the procedure and immediately notice a change in appetite and portion size.  With no incisions there is less pain and faster recovery time.  In fact, the ROSE procedure is usually performed on an outpatient basis and patients are back to work in 1-2 days.  Results are similar to the other traditional forms of revisions, with a much lower chance for complications. 

The N.E.W. Program offers all reasonable surgical revision options and has non-surgical programs to help you restore control over your lifestyle and better manage your weight.  As with any bariatric procedure, lifestyle modifications are paramount to achieving weight loss success after a revision and our comprehensive aftercare program will set you in the right direction.

If you think that you may benefit from one of these procedures, or would like to learn more about them, please call our office at (949) 722-7662 with any questions or to set up an appointment with our surgeons to see if you are a candidate.  Don’t be afraid to ask for help.  The N.E.W. Program will work with you to get you where you’ve always wanted to be – on the road to permanent weight loss.