Today, bariatric surgery is a particularly effective and accessible method of treatment for morbid obesity. If not for bariatric surgery, many obese patients would have very few options in terms of care. Usually, patients are extremely satisfied with their long-term results, namely substantial and sustainable weight loss, control or elimination of chronic diseases such as diabetes, and an overall better quality of life.
However, occasionally there can be a gap between what patients are expecting and their outcome. These patients will often visit our bariatric surgeon in Dubai as he is an expert at performing complex revision surgeries. Complaints from these patients include lower weight loss than expected, regaining the weight they lost, and experiencing uncomfortable side effects or nutritional issues. These complaints are not necessarily the fault of the initial surgeon, they may be unique to the patient or procedure.
It is important to remember that disappointing or non-durable results do not automatically mean permanent failure of treatment. Treating obesity is like treating any other complex health condition and not all methods work equally well on all patients. Combining and redoing different surgical procedures provides us the opportunity to overcome the issues.
Common reasons for unsatisfactory surgical outcomes
1. Individual responses
Every patient’s physiological response to surgery will be different and sometimes a technically correct, perfectly performed procedure might not give the perfect result. In addition, side effects of an otherwise effective procedure may prove to be intolerable, for example heartburn after a gastric sleeve operation or hypoglycemic episodes after gastric bypass. In these cases, a revision surgery can usually resolve the problem.
In other cases, patients might sabotage their results through substance abuse, for example, or they might be prescribed medication some time after surgery that affects their eating behaviour or metabolism and leads to weight regain. In these circumstances, a patient would need to commit changing these habits or finding alternative medications after undergoing the second surgery.
2. Procedure longevity
Not all bariatric procedures are meant to be permanent and by their very nature, some of them require follow-up procedures down the line. For example, after around 10 years a gastric band can start to break down and lose its effect, or a gastric tube can eventually stretch leading to a loss in restriction.
3. Technical errors
Technical mistakes during an initial surgery might show up a year or two post-surgery when the promising weight ceases and the patient starts gaining weight again. This could be caused, for example, if the gastric sleeve or gastric pouch were too large. If the patient follows the lifestyle guidelines their revision surgery can have excellent results.