Over time, gastric sleeves may stretch over time and lead to weight regain. To remedy this situation, endoscopic sleeve revision can be performed to address it.
Under anesthesia, this same-day outpatient procedure restores restriction by inserting a lighted tool into the stomach to tighten a surgically created sleeve created earlier and restore satiation with smaller portions and thus get back on track with weight loss goals.
What is Sleeve Revision?
Endoscopic Sleeve Revision is a bariatric surgery procedure used to restore weight-loss potential following gastric sleeve or gastric bypass surgery. Over time, gastric sleeves may stretch and lose their ability to restrict food intake; during this minimally invasive endoscopic revision procedure, sutures will be tightened around its circumference so as to restore its size and effectiveness.
On this outpatient procedure, general anesthesia will be administered to ensure you remain asleep throughout. An endoscopist will then introduce a tube equipped with camera and suturing device through your mouth and into your stomach to perform the operation.
Endoscopists will use sutures to reduce the size of your stomach into a tube shape, restricting how much food can be eaten at once and alleviating acid reflux (GERD). Sometimes surgeons convert sleeve to gastric bypass procedures in order to address metabolic comorbidities while simultaneously addressing weight recidivism; more studies need to be conducted in order to gauge this method’s long-term durability.
Who is a Candidate for Sleeve Revision?
Sleeve revision surgery is often performed on those who have undergone gastric sleeve gastrectomy and are experiencing weight regain. Over time, sleeve can stretch, leading to larger portions being consumed and eventually weight regain. Sutures are then used to tighten the stomach’s sleeve back up so as to restore restriction and limit weight regain.
Revisional gastric sleeve surgery may also help patients who have experienced complications after previous gastric sleeve procedures, such as staple line leakage or GERD symptoms. Studies indicate that R-ESG could provide effective bariatric surgery revision in this group of patients and offer both weight loss and relief from GERD symptoms simultaneously.
Patients interested in having their sleeve revised will undergo an in-depth medical evaluation to make sure they’re good candidates. A key element for long-term weight control and lifestyle modifications post-surgery success lies within each patient’s commitment and True You team will work closely with them in helping prepare them for this procedure.
How Does Sleeve Revision Work?
As with any weight loss surgery, patients can experience various outcomes. One reason for insufficient weight loss may be sleeve stretching; this can be corrected via endoscopic Sleeve Internal Stenting (SIS).
Your physician can offer this same-day outpatient treatment to tighten a stretched sleeve and restore restriction with this same-day outpatient procedure using an endoscope inserted through the mouth into the stomach, followed by suturing that creates folds or plications to decrease its size and decrease volume in your stomach.
Studies show that this procedure creates a smaller pouch, taking more time and food intake to fill, which in turn decreases food consumption. Studies indicate SIS as an effective treatment option for managing obesity-related comorbidities like hypertension and dyslipidemia, although not recommended. Furthermore, this operation is reversible while showing promising midterm results, with significantly reduced risks of re-gain.
What is the Recovery for Sleeve Revision?
Bariatric procedures do not involve hospitalization; rather, under sedation a doctor will use an endoscope (a narrow tube with light and camera at its tip) to insert stitches that restore your stomach to its original size and shape.
As time progresses, your stomach pouch may expand to allow more food in. Furthermore, the point where your intestines and stomach connect may widen more frequently and cause less restriction than before; leading to weight regain and inhibiting long-term success with your sleeve diet.
Sometimes patients wish to convert their sleeve to a gastric bypass for improved malabsorptive symptoms, like acid reflux. When this is necessary, Dr. Jacob may recommend an duodenal switch as an effective option: although more permanent than sleeve revision procedures, its results tend to be better overall.
