Bariatric Surgery Revisions and Conversions
When a patient gains weight after their primary bariatric procedure – usually several years after surgery, if ever, we evaluate whether it is simply a lifestyle issue, where the patient is not compliant with their post-operative lifestyle, or whether the procedure needs to be converted or revised to offer better weight loss potential.
A bariatric surgery revision involves an adjustment to the primary procedure to make it more effective. This is often when the pouch created during surgery has stretched and this often happens with gastric sleeve or gastric bypass patients who have not been able to maintain their diet and exercise regimen over the long term. Good examples of a revision would be trimming the pouch of a sleeve or a bypass to make it smaller. Other procedures may include endoscopic options to tighten the pouch as well.
A conversion on the other hand is when we perform a second, different surgery to change the type of surgery entirely. Most often, we convert a Lap-Band to a gastric sleeve or gastric bypass. This is because the long-term complications of Lap-Bands have forced many patients to require it removed. Sometimes, the gastric sleeve can also fail to offer adequate long term weight loss or because it causes significant acid reflux. This can then be converted to the gastric bypass.
Risks of revisions and conversions
There are certainly added risks to revisions and conversions of a primary bariatric procedure. These revolve around the scar tissue formed in the surgical area after the primary procedure. As a result, we only consider a revision surgery after we have exhausted all other options for re-starting weight loss. However, despite the added risk, revision surgery is very safe and effective and can be appropriate for some patients.
While insurance coverage for primary bariatric procedures is spelled out in the explanation of benefits of your insurance policy, whether or not an insurance company will cover your revision is determined on a case-by-case basis. We will work with you to get a preauthorization on your insurance plan and submit necessary information to secure the approval.
As part of the preoperative work up for your primary bariatric procedure, you will likely have gone to a seminar and certainly have worked with a bariatric surgeon during your consultation. As such, attending a seminar is not necessary when considering a revision. Instead, please give our office a call so that you can schedule a consultation and understand your options as well as risks and benefits of the procedure of your choice.