Bariatric surgery, specifically the gastric sleeve, has become one of the most popular weight loss procedures worldwide. While it offers effective results for many, some patients may experience weight regain or insufficient weight loss, prompting them to consider a secondary procedure known as a resleeve. A resleeve involves further reducing the stomach size, typically after an initial gastric sleeve surgery has not achieved the desired results.
However, opting for a resleeve is not always the best or safest choice. This article will explore the risks, benefits, and alternatives to help you make an informed decision.
What is Resleeve Surgery?
Resleeve surgery, or revision sleeve gastrectomy, is a bariatric procedure aimed at further reducing the stomach’s size when a patient hasn't achieved their desired weight loss with the initial gastric sleeve. In the original gastric sleeve procedure, about 80% of the stomach is removed, leaving a small sleeve-shaped stomach. Resleeving involves removing an additional portion of the stomach to make it even smaller.
While the concept might sound like a straightforward solution to inadequate weight loss or weight regain, it’s essential to understand the complexities involved.
When is a Resleeve Considered?
A resleeve is typically considered in patients who:
- Have experienced weight regain after the initial gastric sleeve.
- Did not lose a significant amount of weight after the initial procedure.
- Are experiencing issues such as stomach stretching over time, which reduces the surgery's effectiveness.
Although these reasons might make resleeve surgery appealing, it's crucial to weigh the pros and cons carefully before opting for this revision surgery.
The Risks of Resleeve Surgery
Like any surgical procedure, resleeve surgery carries its own set of risks. In fact, since this is a revision surgery, the risks can sometimes be higher compared to the initial operation. Below are some of the critical risks associated with opting for a resleeve:
- Surgical Complications:
Since a resleeve is a secondary surgery, patients are more prone to surgical complications like infections, bleeding, and leaks from the stomach. Scar tissue from the previous surgery can make the operation more complex and potentially more dangerous. - Digestive Issues:
Resleeving the stomach can further restrict the amount of food you can eat, which may cause severe digestive problems. Many patients experience acid reflux, nausea, and difficulty in absorbing essential nutrients. - Malnutrition:
With a smaller stomach, the body’s ability to absorb nutrients can be significantly compromised, leading to deficiencies in vitamins and minerals such as calcium, iron, and B12. Malnutrition can lead to further health complications and a reduced quality of life. - Irreversibility:
Resleeve surgery, like the initial sleeve gastrectomy, is irreversible. Once a portion of your stomach is removed, it cannot be restored. Therefore, opting for a resleeve is a permanent decision, and the long-term effects must be carefully considered. - Psychological Impact:
Many patients feel frustrated or disappointed when they require revision surgery after their initial weight loss surgery. The emotional toll of undergoing another procedure can lead to feelings of failure, depression, and anxiety.
Alternatives to Resleeve Surgery
Before deciding to undergo a resleeve, it’s crucial to consider other available options. Revision surgery should always be a last resort, and there are several alternatives worth exploring:
- Dietary and Lifestyle Changes:
Sometimes, weight regain can be attributed to lifestyle factors rather than the failure of the surgery itself. Working with a nutritionist or bariatric dietitian to fine-tune your eating habits and exercise routines may help you get back on track. - Endoscopic Procedures:
There are non-invasive alternatives to resleeve surgery, such as endoscopic procedures that can help reduce the stomach size or repair stretched areas. These options come with fewer risks than surgery and typically have faster recovery times. - Gastric Bypass Surgery:
For some patients, a gastric bypass may be a better option than a resleeve. Gastric bypass involves rerouting the small intestine and creating a small stomach pouch, which not only limits food intake but also changes how the body absorbs calories. While this is also a more involved surgery, it might provide better long-term results for patients who struggle with weight regain after a sleeve gastrectomy. - Medical Weight Loss Programs:
For those not ready for another surgery, participating in a medically supervised weight loss program may be a viable option. These programs often include a combination of medication, dietary plans, and regular medical check-ins to support sustainable weight loss.
Is Resleeve Surgery Worth the Risk?
Choosing to undergo a resleeve surgery is a significant decision that should not be taken lightly. While the prospect of further reducing the stomach size may seem like a straightforward solution to weight regain or insufficient weight loss, the associated risks can sometimes outweigh the benefits.
Patients who have undergone gastric sleeve surgery often face challenges in terms of long-term adherence to the dietary and lifestyle changes required for continued success. A second surgery may seem like a quick fix, but it may not address the root cause of the weight regain or slow weight loss in the first place.
Who is a Good Candidate for Resleeve Surgery?
While resleeve surgery isn't the right choice for everyone, some patients may benefit from the procedure. Good candidates typically meet the following criteria:
- They are experiencing significant weight regain after gastric sleeve surgery.
- They have not been able to achieve their target weight despite following post-surgical guidelines.
- They are in generally good health with no contraindications to surgery.
- They have discussed all other options with their healthcare provider and understand the risks involved.
It is also critical that patients undergo a thorough evaluation, including psychological assessment, to determine their suitability for the surgery.
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.
