Gastric bypass revision surgery may be necessary or helpful for patients who experience significant weights regain and dumping syndrome symptoms after their initial surgery.
Overtime, for most gastric bypass patients the stomach pouch or the outlet that connects it to the small intestine can stretch.
Dumping syndrome after gastric bypass surgery is when food gets “dumped” directly from your stomach pouch into your small intestine without being digested. There are 2 types of dumping syndrome: early and late. Early dumping happens 10 to 30 minutes after a meal. Late dumping happens 1 to 3 hours after eating. Each has slightly different symptoms, such as abdominal cramping, fast heartbeat, lightheadedness, and diarrhea.
A reduced pouch size will cause your stomach to hold less and cause your stomach to drain more slowly, prolonging your feelings of fullness.
We offer an endoscopic non-surgical procedure to reduce the enlarged pouch and outlet to their original post-operative proportions.
To find out if revision of Gastric Bypass is right for you, it is important that you follow your surgeon’s orders exactly to avoid another procedure if possible.
First your surgeon will want to rule out the following for regain weight and dumpling syndrome before any procedure.
Work with your dietitian: Diet as the cause of insufficient weight loss or weight regains to very carefully track.
Work with your psychologist: to determine whether any emotional issues could be causing your diet or exercise goals to veer off-track
Rule out exercise: as the cause, which is the amount of energy your body burns, patients with an extremely low BMR could have issues with weight loss even if pouch size and dietary habits are where they should be. Your base metabolic rate can be increased if you add more lean body mass (muscle), so if low BMR is a problem your surgeon will most likely have you work with a personal trainer to properly adjust your exercise.
Eating test: your surgeon will measure the amount of food you can eat before feeling full.
Treatment for dumping syndrome: The main treatment for dumping syndrome is changes in your diet these include
Upper GI and endoscopy: In addition to determining whether your pouch and stoma size are an issue, the upper GI and endoscopy can detect issues such as staple line problems, gastro gastric fistula, esophageal abnormalities and Roux limb abnormalities (6).
If stomach stretching or stoma enlargement is identified, a revision procedure may be your only option to halt or reverse the weight regain and dumping syndrome symptoms
This endoscopic procedure is performed using a small flexible endoscope and specialized devices to repair the enlarged pouch and outlet to return them to their original post-gastric bypass proportions.
The scope and suturing devices are inserted through the mouth into the stomach pouch the same way as a standard endoscope. Sutures are then placed around the outlet to reduce the diameter. The same technique may then be used to place additional sutures in the stomach pouch to reduce its volume capacity.
Patient should avoid taking pills for the first week following surgery and opt for liquid medication where possible. Discuss your options for medication with your physician and specialists prior to surgery.
It’s a 45 minutes procedure under general anesthesia.
Patients are discharged the same day of the procedure.
The revision procedure is only a tool and not a cure for obesity, weight loss after revision is always slower than after the original surgery and that it is necessary to eat right and exercise to obtain the best results.
Doctor Tarek Saleh Message: Patient should understand that weight loss results vary from person to person and be aware of the importance of participating in the 12 months program, to maintain their weight loss and avoid regain weight and understand that after the procedure weight regains if it is not combined with appropriate healthy behaviors lifestyle including diet and exercise modifications are not continued.