Should I Do a Resleeve? What You Need to Know Before Deciding

Bariatric surgery, particularly the gastric sleeve procedure, has helped countless people achieve significant weight loss. However, some patients may not experience their desired results over time or may encounter complications requiring further intervention. One option is a gastric sleeve revision, often referred to as a resleeve.

But is a resleeve the right choice for you? Before making a decision, it’s crucial to fully understand what the procedure entails, its risks, benefits, and who is an ideal candidate. This article provides comprehensive insights into resleeve surgery, offering essential information to help you decide whether it's the best course for your weight loss journey.

What Is a Resleeve?

A resleeve is a revision procedure for individuals who have previously undergone a gastric sleeve surgery (also known as sleeve gastrectomy). In the initial surgery, about 80% of the stomach is removed to create a smaller, sleeve-shaped stomach, restricting food intake and aiding weight loss. A resleeve, in essence, involves re-tightening or further reducing the size of the stomach if the initial procedure has not resulted in the desired outcomes.

Patients may seek resleeve surgery for various reasons, such as insufficient weight loss, weight regain, or complications like the stretching of the gastric sleeve over time.

Why Might You Consider a Resleeve?

There are several reasons why a person might consider a resleeve procedure:

1. Inadequate Weight Loss: Some patients do not achieve the desired weight loss after their initial sleeve gastrectomy. This could be due to factors such as hormonal changes, lack of dietary adherence, or other underlying health conditions. A resleeve might help them restart their weight loss journey.
2. Weight Regain: Weight regain after gastric sleeve surgery can occur, especially if the stomach stretches or the patient returns to poor eating habits. A resleeve may help reduce the stomach's size again, potentially facilitating renewed weight loss efforts.
3. Stomach Stretching: Over time, the stomach can stretch, allowing patients to consume larger portions, which can contribute to weight regain. A resleeve can help re-tighten the stomach to prevent overeating.
4. Complications: In some cases, complications such as gastroesophageal reflux disease (GERD) or severe indigestion may prompt the need for a revision surgery to correct issues stemming from the original sleeve gastrectomy.

Eligibility for Resleeve Surgery

Not everyone is a candidate for a resleeve. Several factors determine whether a patient qualifies for this revision procedure, including:

• Initial Weight Loss Success: If you did not experience significant weight loss after your first gastric sleeve surgery, you might be a candidate for a resleeve. However, it is important to identify any behavioral or dietary factors that contributed to the lack of success.
• Stomach Stretching: If your stomach has stretched after the initial surgery and led to overeating or weight regain, a resleeve may be considered.
• Health Status: Your overall health plays a crucial role in determining your candidacy. Those with certain medical conditions, such as heart disease or respiratory issues, may not be suitable candidates for another major surgery. Your bariatric surgeon will assess your health before recommending resleeve surgery.
• Adherence to Lifestyle Changes: Surgery alone is not enough for long-term weight loss. Patients who adhere to lifestyle and dietary changes post-surgery are more likely to be eligible for a resleeve, as it demonstrates commitment to long-term health improvement.

The Resleeve Procedure: What to Expect

A resleeve is typically performed using laparoscopic surgery, which is minimally invasive. During the procedure, the surgeon will access the stomach through small incisions and further reduce its size by removing more of the stomach tissue or re-tightening the existing sleeve.

The procedure is often quicker than the initial gastric sleeve surgery, and most patients can expect to stay in the hospital for a day or two for observation. Recovery time is generally shorter as well, but it’s important to adhere to post-surgery guidelines to promote healing and avoid complications.

Benefits of Resleeve Surgery

Patients who undergo a successful resleeve may experience several benefits, including:

1. Renewed Weight Loss: One of the primary benefits of a resleeve is the potential for renewed and sustained weight loss. By reducing the stomach's size, patients may find it easier to manage portion control and feel full more quickly, which can help in reaching weight loss goals.
2. Improved Health Outcomes: Many bariatric patients experience significant health improvements, including better management of type 2 diabetes, reduced hypertension, and improved cardiovascular health. A resleeve may continue to provide these benefits if the original surgery results were inadequate.
3. Minimally Invasive: Since the procedure is typically done laparoscopically, the risks associated with resleeve surgery are lower compared to traditional open surgery. This also means less post-operative pain and a quicker recovery time.
4. Correcting Complications: If your initial gastric sleeve surgery caused complications such as GERD or indigestion, a resleeve might correct these issues, improving your overall quality of life.

Risks and Considerations

As with any surgical procedure, a resleeve carries risks. It’s important to consider the potential downsides before making a decision:

• Surgical Risks: As a revision surgery, resleeve carries the same risks as any bariatric procedure, including infection, bleeding, or adverse reactions to anesthesia.
• Potential for Complications: While many patients benefit from a resleeve, it’s important to recognize that it might not completely resolve issues such as weight regain or insufficient weight loss, especially if lifestyle changes are not maintained.
• Nutritional Deficiencies: As with the original surgery, reducing the stomach’s size can impact how well your body absorbs nutrients, leading to deficiencies. You’ll need to work closely with your healthcare provider to monitor and manage your nutritional needs.
• Lifestyle Commitment: Success with a resleeve, like all bariatric surgeries, requires strict adherence to dietary and lifestyle changes. Without this commitment, the surgery alone will not result in lasting success.

Preparing for Resleeve Surgery

If you and your doctor decide that a resleeve is the best option for you, there are several steps you’ll need to take before surgery:

1. Consultation with Your Bariatric Surgeon: Your surgeon will review your medical history, current health status, and previous weight loss surgery to determine if a resleeve is appropriate.
2. Pre-Surgery Evaluation: This may include lab tests, imaging, and psychological evaluations to ensure you are both physically and mentally prepared for another surgery.
3. Diet and Exercise Plan: You will likely need to follow a strict diet before surgery to shrink your liver and prepare your body for the procedure. After surgery, your surgeon will provide guidelines on eating habits and activity levels to ensure long-term success.

We highly recommend Dr. Jalil Illan Fraijo, MD. Dr. Illan is a Tijuana bariatric surgeon and one of Mexico's top-ranked, board-certified weight loss surgeons. Dr. Jalil Illan is a recognized expert in laparoscopic surgery who has performed over 16,500 metabolic and bariatric surgeries; 6,000 revision surgeries, and helped more than 22,000 patients.

During this time, he distinguished himself by publishing research articles in Obesity and General Surgery. Afterward, Dr. Illan completed an intensive four-year fellowship program in Laparoscopic Bariatric Surgery with world-renowned surgeon, Dr. Juan Lopez Corvalá. Dr. Jalil Illan completed advanced courses in both Laparoscopic Surgical Techniques and Laparoscopic Gastric Bypass at the prestigious Hospital Oswaldo Cruz Sao Paulo, Brazil – which holds a position as one of the most recognized healthcare institutions in Brazil. He has become one of the few Master Surgeons in Tijuana, Mexico. A distinguished accreditation by the Surgical Review Corporation in Mexico. Dr. Illan has always strived for a better education and overall practice in his medical career.

To learn more about Dr. Illan or to contact him, please visit www.drjalil.com.