Dr Heikal Mahmoud Clinic
weight loss

Redo bariatric surgeries

Obesity is one of the diseases that may pose a threat to a person’s life and researches have proven that obesity is one of the main factors in increased mortality rates, also complications of obesity increase with the neglect of treatment such as heart attacks, strokes, high blood pressure, and diabetes. 

Therefore, many people are looking for different ways to get rid of obesity and its complications. Some resort to the traditional methods of reducing the amount of food and adhering to firm diets, while others resort to exercising to get rid of body fat, and others take some medications. But all these attempts do not succeed, as the results are not satisfactory for most patients. So, some resort to bariatric surgeries which are considered the best therapeutic solution for obesity.

Bariatric surgeries have shown a high degree of success through thousands of successful stories of obese patients who had performed a bariatric surgery such as Gastric Sleeve or Gastric Bypass, and indeed after a short period of time ranging from 6 months to a year, they have been able to lose over half their weight, and that is considered to be a huge success in the world of bariatric surgery.

Points to be taken into consideration in order to have a highly successful bariatric surgery, such as:
1- Choose the surgeon who has sufficient experience to perform such operations and make sure of the doctor’s good reputation and skills.

2- Ensure the cleanliness and sterilization of the place, whether it is a hospital or a center, because any failure at this point may cause the operation to fail and the emergence of serious complications.

3- Make sure of the type of operation that is appropriate for your case, as everyone has an operation that suits him most, depending on the nature of the foods he eats, his lifestyle, and the diseases he suffers from. Of course, the appropriate type of operation is determined by the doctor, not the patient.

Misconceptions about bariatric surgeries:
- Obesity operations have nothing to do with getting rid of the accumulated body fats, but stomach size is reduced in Gastric Sleeve surgery, thus reducing food quantities being ingested, or intestine is bypassed in Gastric Bypass surgery, thus reducing food absorption. 

- Also, bariatric surgeries are now performed without the need for surgical opening, but they are carried out by the laparoscope through very small openings, which led to pain reduction after the surgery, ease of wound healing, and a short recovery period.

First, what are the types of bariatric surgeries?
1- Gastric Sleeve: It is one of the most famous and widespread bariatric surgeries, in which about 75% of the stomach is cut longitudinally, which causes the stomach to be smaller in size and thus there would be difficulty in eating large amounts of food. The wound is stapled and closed using modern smart staplers to prevent leakage occurrence.
2- Gastric Bypass: A link is made between the upper part of the stomach and the intestine, immediately after its large part has been abbreviated. Therefore, the food absorption rate is reduced.
3- Gastric stapling: It was used in the past, in which part of the stomach is stapled, thus reducing the size of the stomach.
4- Gastric banding: A process in which the size of the stomach is controlled and prevented from expanding. 

Second: What are the reasons that may lead to the failure of bariatric surgeries?
The most famous causes that may lead to the failure of bariatric surgeries are:
1- The patient’s non-compliance with the doctor’s instructions. After the operation, the patient should adhere to a specific diet for a month, in which he depends on transparent liquids in the first week and then non-transparent liquids in the second week and starts eating certain foods and proteins in the third and fourth weeks. Therefore, if the patient does not follow this diet, he may show some symptoms such as colic, vomiting, etc., and result in a failure of the operation.
2- The wrong choice of the surgeon, as the doctor’s experience and skill, is one of the most important factors for the success of the operation.
3- The wrong choice of the appropriate type of operation.
4- Excessive intake of sugars, as many patients return to eat sugars and foods rich in calories greedily, because of the ease of their digestion, which causes weight gain again.

Third: What are the cases that need Redo bariatric surgery for a failed bariatric surgery?
1- In case of severe postoperative complications, such as severe pain, persistent vomiting, the appearance of ulcers in the digestive system, or the inability of the body to absorb the nutrients.
2- The difficulty of losing weight and not reaching the ideal weight.
3- In cases of regaining the lost weight again.
4- Not performing the surgery correctly.
5- The patient does not recover from complications associated with obesity, such as hypertension, type 2 diabetes, and high blood cholesterol levels.
6- The appearance of some changes in the structure of the body, such as:
- The formation of a gastric fistula between the pocket and the stomach.
- The slippage of the stomach ring in case of Gastric Banding surgery.

Fourth: Is it possible or impossible to correct failed bariatric surgeries?
The scientific and technological development had allowed the doctor to know the reasons for the failure of the previous operation and how to correct it without pain and with the least possible complications. 

Among the operations that need to be corrected is gastric stapling surgery, as it is corrected by laparoscopic Gastric Bypass to ensure satisfactory results, However, the probability of complications after the Redo bariatric surgeries is higher than the operations that are done for the first time. The Redo bariatric surgeries require great experience and skill to ensure the success of the operation. 

Redo bariatric surgeries are now performed to correct most of the failed bariatric surgeries, but the patient has an important role in the success of the operation, as his commitment to the instructions improves the chances of success of the operation. 

Fifth: What are the different types of redo bariatric surgeries?
The First Type: It has the goal of completely canceling the failed surgery and restoring the natural shape of the stomach and intestine.
The second type: It aims to correct and modify the error in previous surgery, to improve the results and get rid of obesity complications.
The third type: It is done to perform another type of bariatric surgery.

Correction Surgery must be performed in case of occurrence of these complications and side effects:
In case of the appearance of these symptoms, a surgical operation is required to correct the failed previous bariatric surgery.
1- Intestinal obstruction.
2- Gastric ulcers.
3- Continuous vomiting.
4- Dumping syndrome.
5- Formation of gallstones.

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