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Options for a failed gastric sleeve surgery

 
Hi everyone, I’m Nina and welcome to Mexicali Bariatric Center. On our last video we were discussing a failed gastric surgery, and on today’s video I would like to talk to you about the options we have for somebody that has had a failed gastric sleeve due to the construction of the sleeve itself. This has nothing to do with habits or anything else that might cause you to fail.
 
The first option is resleeving, we can go in and completely redo your sleeve. This is a good option when we see that patients either have a very large sleeve, so large that we can go in and remove i.e 50% of the stomach and make it so much smaller that someone can lose, let’s say, another 100 pounds. Or someone might have a very large fundus and of course it will stretch, so, again, removing the fundus will give the patient very good results.
 
But if you need to lose, let’s say, 100 pounds, and the sleeve is a little bit on the larger side but not very big, then the doctors would not recommend that. It will not give you the restrictions you need to get to your weight goal. In those cases we recommend something else: go to a DS surgery or the SADI-S. You have the option of making the sleeve smaller and doing the malabsorptive part. In certain cases that is what we recommend, if it’s a little bit larger we say make it smaller, it will give you the immediate effect of the restriction plus the malabsorption, so you’ll have better results. There are some patients that want to keep their sleeve as it is and only want the second part, but just know that if the sleeve is on the larger side the weight loss would be much slower. You’ll get there, but it will take longer. So that is something to consider.
 
Now, you have the option of having the traditional DS or the SADI-S. The SADI-S is the single anastomosis which offers some benefits. It’s a little bit less malabsorptive and less risk of some complications. We have some information on our website. We are finding that patients contacting us about the SADI-S are usually patients that have a very small sleeve and they just want to lose the last 50 pounds or so, so they go for the SADI-S to lose that amount of weight and keep it off long term. We have also have some patients that don’t need to lose that much weight but their sleeve is larger so they want to make it smaller, and then they don’t need that much malabsorption of the traditional DS so they go for the SADI-S. It’s up to you. We do make recommendations and each case is different. Each revision surgery is different, but ultimately you decide.
 
Lastly, the option we recommend for patients with a failed sleeve is the gastric bypass. The natural progression with the sleeve is the DS. You already have the first part done. But there are some situations that for medical reasons the doctors will recommend the gastric bypass. The most obvious example is when you have a very severe acid reflux and you’re having trouble controlling it with medication, then the doctors will recommend a gastric bypass done. The bypass will help you take care of the excess weight you still have and also it takes care of the reflux. So that would be a good options.
 
If you have any questions, if you want to send us x-rays, if you want our doctors’ opinion on whether your sleeve is effective or is there something to do with its construction, send them over and feel free to call us, we’ll be very happy to give you our opinion with the years of experience that our doctors have.
I hope this helps, I hope to see you soon. If you have any questions remember to visit mexicalibariatric.com or call us toll free at 888-344-3916.