Understanding Endoscopic Revision of Prior Bariatric Surgery

Obesity is a common health concern, and bariatric surgery is one of the many ways doctors treat it. Bariatric surgery typically results in significant weight loss. However, some patients gain some of the weight back. Typically, the weight regained after a surgical weight loss procedure is 15–25% of the total weight lost.

Sometimes, the weight regain is due to the stretching of the gastric sleeve or stomach pouch. Endoscopic bariatric surgery revision is a treatment option for such cases. Below, we dive into endoscopic revision, its purpose and its benefits.

What Is Endoscopic Bariatric Surgery Revision?

Endoscopic revision is the term for nonsurgical, minimally invasive procedures that restore the original surgical anatomy. It leverages an endoscope, a medical device that resembles a thin tube and is equipped with a camera and light. Endoscopic revision is a safe and effective treatment for weight regain caused by a stretched gastric sleeve, outlet or stomach pouch.

Endoscopic revision is performed on patients who previously underwent gastric bypass, sleeve gastrectomy, or endoscopic sleeve gastroplasty but have had significant weight regain post-surgery. How your care provider approaches endoscopic revision depends on the type of bariatric surgery you had.

Endoscopic Revision vs. Revision Bariatric Surgery

Both endoscopic revision and revision bariatric surgery are procedures designed to address issues that arise after a previous bariatric procedure. However, they differ significantly in how they are performed and the recovery involved.

Revision bariatric surgery is a surgical procedure performed through small abdominal incisions, typically using laparoscopic techniques. In some cases, an open surgical approach may be necessary depending on the patient’s anatomy or the complexity of the revision.

Meanwhile, endoscopic revision is performed through the mouth using an endoscope and other specialized tools. The doctor does not make any external incisions, making this approach minimally invasive and non-surgical.

Revision bariatric surgery is generally more complex and is often used to address issues beyond a stretched pouch, outlet, or sleeve. These may include complications such as leaks, strictures, fistulas, or gastric band-related problems. As a result, recovery is typically longer, and a hospital stay may be required.

In contrast, endoscopic revision is usually performed as an outpatient procedure, allowing most patients to return home the same day. The recovery period is also generally much quicker.

In summary, endoscopic revision can be an excellent alternative to revision bariatric surgery for patients who want to avoid surgery, prefer a faster recovery, and do not have bariatric complications that require a surgical repair.

Types of Endoscopic Bariatric Revision Procedures

Gastric Bypass Revision

During gastric bypass surgery, your surgeon creates a small pouch by separating the upper portion of the stomach from the rest. The gastrojejunal anastomosis or outlet connects the stomach pouch to the small intestine.

If the stomach pouch, outlet or both become dilated, this could hinder your weight loss goals. The stomach can accommodate more food, and it could take longer for a patient to feel satisfied. Other unpleasant symptoms, such as nausea and diarrhea, could also occur.

In endoscopic gastric bypass revision, your doctor reduces the size of the pouch, outlet or both, restoring it to how it was after your original gastric bypass. The results help you eat less and feel full sooner, allowing you to take control of your weight loss journey.

Sleeve Gastrectomy Revision

During a sleeve gastrectomy, the surgeon removes a large portion of the stomach, creating a banana-shaped sleeve. However, this sleeve can stretch over time, leading to weight regain.

Sleeve gastrectomy revision involves shrinking the stretched sleeve to its original post-surgery size using an endoscope and other specialized instruments inserted through the mouth.

Endoscopic Sleeve Revision

Patients could regain weight after an endoscopic sleeve procedure for many reasons. These include the stretching of the stomach and stomach dilation caused by broken or dissolved sutures. This stretching or dilation allows the stomach to hold more food and negatively impacts satiety, potentially contributing to weight regain.

The endoscopic sleeve revision procedure is similar to sleeve gastrectomy revision. During the procedure, your doctor will use an endoscope and specialized tools to place additional sutures. This re-tightens the gastric sleeve, helping you feel full faster and with less food.

Choosing the Right Type of Endoscopic Revision Procedure

The right endoscopic revision for you depends on various factors, including:

• The type of bariatric surgery you previously underwent
• How much weight you regain
• The underlying cause of your weight regain
• Your health condition

It’s crucial to talk to your doctor to determine the best approach for your situation. A qualified healthcare provider can guide you through your options and answer any questions you may have about the procedure.

Explore Bariatric Surgery Revision Procedures at Everself

Everself offers longer-lasting weight loss solutions tailored to our patients’ unique needs, goals and lifestyles.

Our cutting-edge weight loss treatments are performed by some of the most renowned medical professionals in the field. These procedures include endoscopic bariatric surgery revision procedures as well as ESG Stomach Tightening® and gastric balloon treatment.

Let us be your trusted partner in your weight loss journey. Request a free consultation today.