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Can I redo the sleeve surgery cause I gained 20 kilos after 4 years?
13 أكتوبر 2014
رأي ثانوي

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د. Zakia Dimassi طب الأطفال
There are no known effective procedures for weight regain after bariatric surgery. The stomach pouch and outlet to the small intestine may get slightly larger over time following gastric bypass. However, there is no well-established association between pouch and outlet size and weight gain. After sleeve gastrectomy, the stomach will stretch. This is not likely to change the feeling of fullness.
If you had previous weight loss surgery, you might be a candidate for gastric revision surgery if you're having problems related to that surgery such as recurrent vomiting and abdominal pain. With gastric revision surgery, it is sometimes possible to convert prior gastric surgery, such as a vertical banded gastroplasty, jejuno-ileal bypass, or gastric stapling to a gastric bypass, or to redo a previous gastric bypass. The following criteria must be met in order to repeat this type pf surgery:
a. Conversion to a sleeve gastrectomy, Roux-en-Y gastric bypass, or biliary pancreatic diversion/duodenal switch is considered medically necessary for members who have not had adequate success (defined as loss of more than 50 % of excess body weight) 2 years following the primary bariatric surgery procedure and the member has been compliant with a prescribed nutrition and exercise program following the procedure; OR
b. Revision of a primary bariatric surgery procedure that has failed due to dilation of the gastric pouch, dilated gastro-jejunal stoma, or dilation of the gastro-jejunostomy anastomosis (where the stomach is stitched to the intestines) is considered medically necessary if the primary procedure was successful in inducing weight loss prior to the dilation of the pouch or GJ anastomosis, and the member has been compliant with a prescribed nutrition and exercise program following the procedure; OR
c. Replacement of an adjustable band is considered medically necessary if there are complications (e.g., port leakage, slippage) that cannot be corrected with band manipulation or adjustments.
A repeat surgery on the stomach is more difficult because scar tissue has formed around the stomach and organs that are in close proximity, such as the spleen, liver, and pancreas. During revision surgery, some of the scar tissue needs to be dissected free, and the process may cause injury to these organs. Patients should understand that revision surgery carries greater risk of complications.
Insurance usually does not pay for revision surgery that is done due to weight regain.
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