LAPAROSCOPIC/ROBOTIC BARIATRIC REVISION SURGERY
Dr. Chiasson has had a longstanding interest in revision bariatric surgery. From his point of view, it is important to offer all revision bariatric weight loss options. He also understands that bariatric operations can also be associated with significant complications such as severe heartburn/GERD after Sleeve Gastrectomy. He is well-known in the community to help manage these difficult problems.
Who is a candidate for a Laparoscopic/Robotic Revision Bariatric procedure?
Individuals who have had a prior weight loss operation may experience inadequate weight loss or weight regain over time. Laparoscopic revision procedures are generally intended for those individuals who still need to lose a significant amount of additional weight to reach their goals. These procedures are used in conjunction with our supervised weight loss program, which offers both dietary counseling and the addition of newer weight loss medications.
What are the Laparoscopic/Robotic Revision Bariatric Weight Loss Procedures?
- Revision of Sleeve Gastrectomy (Conversion to SADI)
This laparoscopic procedure provides for significant additional weight loss following a prior Sleeve Gastrectomy by adding a malabsorptive component. During the surgical procedure, the first portion of the duodenum is divided while keeping the pylorus intact. A connection is then created to the small intestine 250-300 cm from the junction of the colon and small bowel. This procedure changes the normal way that digestive juices break down food. This limits how many calories are absorbed and contributes to more weight loss.
The ”SNAP” procedure is a newer alternative that has been described. It is a combined Endoscopic / Laparoscopic/Robotic procedure connecting the Duodenum to the Ileum (distal small bowel) using the GI Windows FLEX Self-forming Magnetic (SFM) dynamic compression anastomosis device. This device is presently undergoing FDA evaluation and is not yet available.
Similar to the SADI procedure, a connection is then created to the small intestine 250-300 cms from the junction of the colon and small bowel. This procedure changes the normal way that digestive juices break down food. This limits how many calories are absorbed and contributes to more weight loss.
- Revision of Gastric Bypass (Conversion to SAJI Bypass)
The Single Anastomosis Jejunal-Ileal Bypass (SAJI Bypass) is Laparoscopic/Robotic procedure results in significant additional weight loss by adding additional malabsorption. During the surgical procedure, the small bowel limb emptying the gastric pouch is divided just before it reaches the jejuno-jejunostomy connection. From there, a connection is created to the ileum, which is measured 250-300 cm from the junction of the colon and the small bowel. As a result, the small bowel is bypassed, which changes the normal way that digestive juices break down food. This limits how many calories are absorbed and contributes to more weight loss.
- Laparoscopic Revision of Single Anastomosis Duodenal Switch
This laparoscopic procedure is intended for patients who require significant additional weight loss following prior Single Anastomosis Duodenal Switch with Sleeve surgery. In this case, an additional malabsorptive component is provided. During the surgical procedure, the small bowel is divided proximal to the prior duodenal-intestinal anastomosis. It is then re-connected 150 cm distal to the duodenal-intestinal anastomosis to create Roux-en-y anatomy consistent with the traditional Duodenal Switch. This results in creating a shorter common channel for nutrients to be absorbed and thus contributes to more weight loss.
What should you expect after a Laparoscopic Revision Bariatric procedure?
Laparoscopic/Robotic Bariatric Revision procedures are performed in the outpatient setting under general anesthesia. They usually take about one hour. I utilize the latest pre-emptive and peri-operative pain management protocols so that patients experience minimal discomfort and nausea after the procedure. Most patients are able to return to a normal diet and activities within a few days. Laparoscopic surgery incisions are very small and tend to be at very low risk for infection or the development of hernias.
Advantages of a Laparoscopic/Robotic Bariatric Revision procedure?
These procedures add a new dimension to a patient’s prior bariatric weight loss surgery anatomy by adding additional malabsorption and offering the patient another opportunity to embark on their weight loss journey to reach their goals.
Can the LINX Device be used to treat GERD following Sleeve Gastrectomy?
Severe heartburn is a common problem following Sleeve Gastrectomy. It can also be a problem for some patients following Gastric Bypass or Single Anastomosis Duodenal Switch Surgery. The LINX device has been approved by the FDA based upon the “Relief Study” results for the treatment of severe GERD following Sleeve Gastrectomy in patients with a BMI < 35.
READY TO GET STARTED WITH DR. CHIASSON?
In 2016, more than 1.9 billion adults, 18 years and older, were overweight. Of these over 650 million were obese. You are not alone and you do not need to feel any less of a person if you are overweight or obese. Take action now and increase your quality of life with Dr. Patrick Chiasson, the leading Tucson Bariatric Surgeon.