Revisional Bariatric Surgery: Weighing the Benefits and Complications
While revisional bariatric surgery may benefit the majority of patients who request it, the procedure doesn’t come without certain risks, according to a recent study done to determine if the surgery is truly safe and effective.
Nevertheless, most patients report they have had a positive experience with revisional weight loss surgery, the researchers discovered, in spite of any complications that may have occurred.
An increasing number of revisional bariatric surgeries are being done now, mainly to correct what patients view as intolerable complications stemming from the original procedure, but also to make adjustments when the patient has not been successful at losing weight.
Researchers found that when revisional bariatric surgery is done in experienced weight loss surgical centers, it is generally successful and doesn’t present any major health concerns.
The study involved 56 patients who originally had either gastric bypass surgery or the biliopancreatic diversion procedure, and who underwent revisional bariatric surgery between 1995 and 2008. The patients’ reasons for having the second surgery varied, from severe nutritional complications (15 patients), unsatisfactory weight loss (39 patients), and adverse complications rooted in the original procedure, particularly problems involving the blocking or narrowing of the digestive tract (2 patients).
The patients included in the study were tracked for an average of 102 months following their revisional surgery. Both negative and positive experiences were reported, such as:
- Complications that arose soon after the surgery (within 30 to 90 days) occurred at a rate of almost 34% (19 patients). The issues included acute renal failure, pneumonia, infections in the wound, leaking bile, anastomotic leaks, and obstructions in the small bowel.
- Complications emerging more than 90 days after surgery were seen in slightly more than 23%. These included the narrowing of the passageway between the stomach and intestine, protein malnutrition, and hernias at the incision site.
- Patients who reported inadequate weight loss had a significant drop in BMI, from an average of 55.4 to an average of 35. On average, patients lost 68.9 percent of their excess body weight.
- Patients who had experienced problems with insufficient nutritional intake said all clinical signs and symptoms of protein malnutrition were resolved to their satisfaction.
- Two patients who reported having intolerable complications after the original procedure eventually said their situations had turned positive and they were pleased with the outcomes.
Choosing which type of revisional bariatric surgery to have depends on the type of procedure that was done originally. Gastric bypass patients who opt for revisional surgery may decide to have any of the new, safer non-surgical techniques, such as StomaphyX or ROSE. At a time when the number of bariatric surgeries is on the rise, it is essential that revisional procedures are deemed medically safe and effective in order to protect the health of the patients.