Non-Surgical Gastric Sleeve Revision Procedure Can Give Bariatric Surgery a Second Chance at Success

Dr. Christopher McGowan
May 29, 2024

Gastric sleeve, or vertical sleeve gastrectomy, is one of the most commonly performed bariatric surgeries available today. It’s a very effective procedure overall, but because obesity is a chronic and relapsing condition – it doesn’t work long-term for every patient. Some patients experience significant weight loss at first, but their progress stalls or they even regain the weight they’ve lost since surgery. The good news is you don’t need another surgery to fix it. Today, there are non-surgical options such as Endoscopic Gastric Sleeve Revision available to help you give your surgical sleeve gastrectomy a second chance at success.

Reasons for Revision

There are several reasons that a gastric sleeve may need to be revised, either surgically or through an endoscopic procedure like those offered at True You Weight Loss. These include:

  • Inadequate weight loss
  • Weight regain
  • Gastroesophageal reflux disease (GERD)
  • Stretching of the gastric sleeve

Before taking a closer look at gastric sleeve revision, when it’s indicated, and how it can help you achieve your weight loss goals, let’s first learn more about gastric sleeve surgery.

Gastric Sleeve Surgery, Explained

In a vertical sleeve gastrectomy, which is typically done laparoscopically, a surgeon makes several small incisions in the abdomen to introduce surgical tools, then cuts, staples, and removes 80% of the stomach. The remaining stomach is reduced to a banana-shaped “sleeve.” This significant reduction in the stomach’s size drastically reduces how much food a person can eat. The procedure also removes the part of the stomach that produces the “hunger hormone” ghrelin.

Though gastric sleeve surgery does not require a full opening of the abdomen, it is still a major surgery, performed under general anesthesia (which requires patients to be put on a ventilator). The procedure itself takes about an hour and most patients take at least another hour in the recovery room to fully wake up from anesthesia.

Barring any surgery complications, most patients will go home from the hospital after two or three days. The laparoscopic incisions heal much more quickly than larger abdominal incisions, and a full recovery usually takes 4 to 6 weeks.

Patients can only drink clear liquids for the two days preceding surgery and the full week after. For three weeks after that, patients can start introducing pureed foods to their diet. Most patients can return to eating solid, healthy food about a month after surgery.

Revision Procedures for Gastric Sleeve

Oftentimes, gastric sleeve surgery is effective at first, but over time patients may start to experience weight regain. Gastric stretching is very common after patients achieve the bulk of their weight loss in the first 18 months to two years following surgery. A phenomenon called “portion creep,” when patients gradually begin eating and tolerating larger amounts of food at one time, can both cause and be caused by this stretching of the gastric sleeve.

In fact, the average patient regains 30% or more of the original weight loss, and more than 1 in 5 bariatric surgery patients will eventually regain all of their weight. In order to stop weight regain and help jumpstart weight loss, many patients will elect to have a gastric sleeve revision.

Patients have several options for gastric sleeve revision, including:

  • Endoscopic sleeve revision, which tightens the sleeve gastrectomy in a 30-minute, non-surgical, outpatient procedure.
  • Conversion to duodenal switch (DS), a complex surgery that attaches the stomach sleeve further down the intestines, thereby bypassing a length of intestine and reducing the amount of food that is absorbed.
  • Conversion to modified switch (SADI), a modification of the duodenal switch procedure that uses just one cut to the intestine to create a loop attached to the stomach.
  • Conversion to gastric bypass, surgery that bypasses most of the stomach and the duodenum, creating a small stomach pouch that connects to the rest of the small intestine.

Non-Surgical Gastric Sleeve Revision

True You Weight Loss specializes in endoscopic weight loss procedures, including non-surgical gastric sleeve revisions. The procedure is ideal for patients who had a sleeve gastrectomy more than two years prior and lost weight initially, but have since regained. A sleeve revision can help patients get back on track by restoring a sense of stomach fullness and satiety from smaller portions of food.

In an endoscopic gastric sleeve revision, highly skilled gastroenterologists utilize an endoscopic suturing system to tighten the gastric sleeve from the inside.

True You Weight Loss uses cutting-edge endoscopic technologies to perform gastric sleeve revisions; without the need for major abdominal incisions, the risk of bleeding, infection, or injury to the stomach is less than one percent. Recovery time is minimal –patients return home same-day and return to work after about two or three days of rest.

True You Weight Loss employs dietitians who work with patients to make the necessary adjustments to diet and physical activity to ensure they’re seeing maximal results and can maintain weight loss over the long term.

Dr. Lauren Donnangelo, Dr. Daniel Maselli, and Dr. Christopher McGowan are all triple board-certified in gastroenterology, internal medicine, and obesity medicine; they are recognized leaders in endoscopic weight loss procedures. True You Weight Loss has helped patients from 45 states and 10 countries.

Ongoing Support for Success

The high level of expertise, lifelong personalized support, and 24/7 physician access offered by our team of physicians is unparalleled. We are the highest volume bariatric endoscopy weight loss center in the United States and we have helped thousands of patients bolster their weight loss journey with a gastric sleeve revision.

If you’re considering a revision procedure for your gastric sleeve or want to learn more about your options, please contact us to request a consultation.

Dr. Christopher McGowan
Dr. Christopher McGowan

Dr. Christopher McGowan, MD, a leader in endobariatrics, specializes in non-surgical obesity treatments and is triple-board-certified in Internal Medicine, Gastroenterology, and Obesity Medicine. Renowned for pioneering endoscopic sleeve gastroplasty (ESG) with over 2,000 procedures, his global influence and research contributions define him as a top expert.

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