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What we can do depends a lot on what the previous operation has been. You should be aware at the outset that a further procedure is not to be entered into without very careful assessment by us and the understanding that such a procedure carries risks which may be greater than those of the initial operation.
The following is provided as a guide to the possibilities only and is not to be taken as individual medical advice.
In most cases we can offer you an alternative procedure. The option of a gastric banding procedure has been used in this situation, but in general we have not found this approach to be effective. Our advice and that of the majority of international experts in the field is the conversion of your stapling procedure into a gastric bypass. This is a very major operation in someone who has had previous abdominal surgery and may not be able to be performed by keyhole (laparoscopic) technique.
The risks of complications from this procedure are greater than for the same operation done where there has not been previous surgery and this will be discussed with you in full at your consultation.
The majority of patients who have had their gastric stapling converted have had very significant weight loss and a much improved quality of life.
We have performed around 3,000 gastric banding operations and we know that 15 – 20% of these don’t achieve a satisfactory result. We have significant experience in helping patients in this situation.
As a first step we would always check to see if the Band can be made to work. This involves a consultation with one of our surgeons and assessment by our dietitian and counsellor. Tests including X-Ray and gastroscopy will be required.
In some cases it may be possible to put in a new Band but our experience in general is that second Bands are not as effective.
If we do not think that the Band procedure can be resurrected, then we have 2 alternatives, laparoscopic sleeve gastrectomy and laparoscopic gastric bypass. The Band will be removed first and then a further procedure performed at a later date, usually about 3 months after removal of the Band to aid in internal healing prior to undertaking the next procedure.
The decision as to whether the sleeve gastrectomy or the gastric bypass is the better procedure is very complex and will require careful discussion with you. It is beyond the scope of this article to explain the issues.
In either case the majority of patients will experience significant further weight loss and improvement in quality of life after the revision procedure.
You must be aware that complication rates of revisional procedures are greater than those where previous surgery has not been performed and we will discuss this with you in full and openly at consultation before going ahead with any further procedure.
Like any of the operations for weight there is a small failure rate for the sleeve gastrectomy.
The common reason for a sleeve gastrectomy not working is that the remaining stomach stretches so that the capacity of the stomach is greater thus enabling larger amounts of food to be consumed.
A less common problem is severe gastric reflux making life a misery despite good weight loss.
As a first stage you will need a thorough assessment by one of our surgeons, our dietitian and our counsellor. X-Rays and a gastroscopy will usually be required.
Two approaches are possible. Firstly it may be possible to “trim” the stretched out stomach to reduce its capacity and achieve the desired result. This can usually be performed by keyhole (laparoscopic) technique.
The alternative is to convert the sleeve gastrectomy to a gastric bypass. This can also usually be done by keyhole technique. If the problem is reflux, this is the only option.
Some risks are involved with either surgical option and these will be discussed with you very thoroughly prior to proceeding with any procedure.
View more information about Gastric Bypass.
The gastric bypass in general is a very successful long term weight loss procedure. Like all weight loss operations there is a failure rate. Failed gastric bypass operations present one of the most difficult problems faced by bariatric (weight loss) surgeons and their patients all over the world.
There are several reasons why a gastric bypass may not work and these would need to be thoroughly assessed by one of our surgeons, our dietitian and counsellor. X-Rays and gastroscopy will be needed.
The options are beyond the scope of this article and there is no international consensus on the best way to manage such problems.
We would be very happy to discuss the options with you.
If you are already one of LapSurgery Australia patients you will need only to have a current referral from your general practitioner. If you are not a LapSurgery patient already, you will need a referral from your general practitioner and If at all possible you should ask the surgeon who performed your previous operation to provide you or us with a summary of the procedure performed.
As we do not work in the public hospital system you will need to have, or to be prepared to take out, appropriate private health insurance*. We will not perform these types of weight loss procedures on patients without suitable private health insurance as hospital stay can be prolonged, further procedures may be needed and often a period in the intensive care unit may be required, all of which can involve very significant and unpredictable costs along with considerable stress to you and your family.
Revisional bariatric (weight loss) procedures are extremely complex, technically difficult, time consuming and requires two of our surgeons at each such operation. At LapSurgery we have the experience, expertise and multidisciplinary setup and staffing to perform these types of procedures.
Although most of the hospital costs will be covered with your private health insurance, there will be significant out of pocket (OOP) costs if your previous weight loss procedure has not been performed by us. Very substantial discounts apply to those who have had previous procedures performed by LapSurgery surgeons.
As costs may vary depending on the type of procedure performed we can only give guidelines but for patients who are not currently LapSurgery Australia patients the out of pocket costs are between $4,700 and $6,500. For patients of LapSurgery Australia who have had previous weightloss surgery please speak to our staff regarding your out of pocket costs as these will vary depending on what type of surgery you have previous had.
Please do not hesitate to ring our helpful and knowledgeable staff on 9760 2777 for further information or email us via our contact form.
*Not all health fund tables cover weight loss surgery. Some health funds are easier to deal with than others. It is strongly recommended that you ring our weight loss coordinator on (03) 9760 2777 to check if your existing fund covers you and for advice on the better funds if you are considering taking out private health insurance.
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