Even though Vertical Sleeve Gastrectomy (VSG), commonly known as sleeve, is one the most effective kind of surgeries regarding weight loss, there are a number of patients not losing enough weight after undergoing this operation.
One of the most common reasons for this is an ineffective technique used by the surgeon at the time of constructing the sleeve. Not all sleeves are made the same so not all sleeve surgeries result in the expected weight loss. The most common reasons for a poorly constructed sleeve are:
- Lack of skill.
- Trying to keep costs of materials low (staples, mainly).
- Trying to keep OR time to a minimum to save money.
There are other reasons why a sleeve may not be offering you the weight loss results you were hoping for like the following:
- Stretching your stomach by overeating constantly.
- Very long intestines.
The following are the two possible paths to fix all of the above with a Revision surgery:
- For a stretched stomach or a very large sleeve, undergoing re-sleeving via a Revision Surgery may be enough. This will give you added restriction.
- In some cases, a gastric bypass or duodenal switch should be performed so patients improve a certain metabolic and/or food malabsorptive aspect of their entire process, thus complementing the restriction of the Vertical Sleeve Gastrectomy.
Surgeons at Mexicali Bariatric Center specialize in revision surgeries, sleeve reconstruction is among the most regularly performed. Over the years, we have found that it is common to find sleeves with an excessively big fundus or antrum or in some cases an overall large sleeve. We will reconstruct the sleeve to make it uniformly narrower, giving patients a better tool to work with to achieve the expected results.
A barium swallow x-ray is the best way to determine if the sleeve was efficiently constructed to start with and if reconstruction is an option for achieving significant results. Nevertheless, there are some symptoms that can indicate the possibility of needing a sleeve reconstruction. These include the following:
- Eating large amounts of food too soon after surgery and thereafter.
- Not feeling restriction from the sleeve.
- Not losing a significant amount of weight vs someone who loses and regains.
How do I know if switching to a malabsorptive surgery is the right choice for me?
You might need to consider a DS or a gastric bypass if reducing food intake is not enough for you to lose weight. It’s not uncommon for some patients to struggle with weight loss even when following the post-op diet appropriately and having a healthy lifestyle overall. If this is the case, a malabsorptive procedure is the way to go, for more information on when the re-sleeve isn’t recommended refer to Why a Resleeve or Sleeve Reconstruction Surgery is NOT Recommended.
It is worth noting that when undergoing the process of a Revision Surgery with the purpose to convert from Vertical Sleeve Gastrectomy to a Duodenal Switch, there is less risk than that of performing the latter as a first-time weight loss surgery, because a completed VSG surgery involves part of the process that the Duodenal Switch surgery requires, thus resulting in a shorter procedure.
Some patients inquire about converting from a sleeve to a mini gastric bypass (MGB) mainly because they feel they do not need to lose a lot of weight or because they want to save money.
We don’t particularly recommend it since it has side effects that the full gastric bypass does not. The difference between these is that the mini gastric bypass (MGB) skips a part of the procedure called Roux en Y (RNY), which prevents the bile acids from flowing into your new pouch.
The MGB puts you at risk of experiencing biliary reflux. Talk to your doctor about having a full bypass with less malabsorption if this is your concern.
If you’re unsure of the right procedure for you, at Mexicali Bariatric Surgery we are happy to provide all the information needed for your revision surgery. Please contact us at (888) 344 3916 US Toll-Free or www.mexicalibariatric.com