A new option for those who have had stomach surgery but have not yet achieved the desired results!!

Weight loss surgery or Bariatric Surgery is a popular and highly effective option for those with severe obesity (Morbid Obesity). By reducing the size of the stomach or altering the digestive tract, it helps limit food intake and energy absorption, leading to continuous weight loss

However, in some cases, even after undergoing weight loss surgery, it is found that…

Weight loss does not reach the target
Weight regain
Complications after surgery such as severe acid reflux, leaks, chronic wounds, or nutrient absorption problems

In these cases, doctors may consider having the patient undergo repeat weight loss surgery or Re-Do Bariatric Surgery

What is Re-Do Bariatric Surgery or repeat weight loss surgery?

It is repeat weight loss surgery for patients who have previously undergone surgery but experienced problems or did not achieve the desired results. This repeat surgery requires specialized techniques and extensive experience from the surgeon because the patient’s digestive tract has already been altered once, making the repeat surgery more complex

Common reasons why repeat surgery is needed

Weight regain caused by stomach expansion over time or inappropriate eating behaviors such as frequent snacking or excessive consumption of sweets
Failure to achieve desired results in the first surgery Some patients lose very little weight, especially those who underwent restrictive procedures such as Gastric Banding
Complications after surgery such as severe acid reflux, leaks, non-healing wounds, or abnormal nutrient absorption

Criteria for patients to undergo repeat surgery (revision/conversion surgery)

In cases where patients have insufficient weight loss or weight gain as follows

At least 2 years have passed since the previous weight loss stomach surgery
Weight loss is less than 50% of excess weight
Weight remains more than 30% above ideal body weight
For other cases of repeat surgery, multidisciplinary consultation with other specialists is recommended

What are the methods of repeat surgery?

Repeat surgery is considered based on the previous surgical method and the patient’s current condition, such as

From Sleeve Gastrectomy → converted to Roux-en-Y Gastric Bypass
Used in cases of acid reflux or the need for additional weight loss
From Gastric Banding → converted to Sleeve or Bypass
If device displacement or slippage is found
Correction of specific complications such as closing leaks or repairing abnormal digestive tracts

Advantages of repeat surgery

Helps resume continuous weight loss
Reduces risk of comorbidities such as diabetes, hypertension, and dyslipidemia
Corrects complications from previous surgery
Improves quality of life

Precautions

Repeat surgery carries higher risks than the first surgery
Requires thorough evaluation by a specialized medical team
Should be managed by a well-equipped obesity surgery center with a comprehensive medical team, technology, and continuous post-operative care

Who is suitable for Re-Do Bariatric Surgery?

1. Those who have regained weight after surgery

Although initially successful in weight loss, inappropriate eating behaviors have led to weight regain
The previously reduced stomach has expanded, allowing increased food intake

2. Those who did not lose weight as targeted after surgery

Common in patients who chose a surgical method unsuitable for their eating behavior or comorbidities, such as Gastric Banding

3. Those with complications from previous surgery

Such as severe acid reflux, frequent vomiting, leaks at suture sites, non-healing wounds, or abnormal nutrient absorption

4. Those with chronic nutritional problems

Such as severe vitamin and mineral deficiencies, fatigue, or effects on other organs such as hair loss, brittle nails, and weakened immunity

5. Those who are physically and mentally prepared

Must undergo evaluation by specialized doctors, nurses, psychologists, and nutritionists to plan the safest and most appropriate repeat surgery

Advice for those considering Re-Do Bariatric Surgery

If you have had weight loss surgery but did not achieve the expected results or have complications affecting your quality of life, do not hesitate to consult a doctor

At Phyathai 2 Hospital, we have a specialized bariatric surgery team along with a multidisciplinary team including specialists in internal medicine, psychology, and rehabilitation medicine who collaboratively plan comprehensive treatment for the safest and most sustainable results for you

Assoc. Prof. Dr. Wisit Kasetsermviriya

Specialist in Advanced Minimally Invasive Surgery