Resleeving & Revising Other Bariatric Surgeries

Perhaps you’re unhappy with your gastric bypass or Lap Band and are wondering whether you can convert your initial procedure to a gastric sleeve. Or maybe you already got a sleeve and now question whether a resleeve would help you lose more weight. Everything about these “re” surgeries is highly individual, but I’ll do my best to provide some overarching answers.

Can you convert a Lap Band into a sleeve?
Yes! In fact, I’ve done exactly that for my mom. I placed a band in my mom in 2006, when it was the “next big thing” in bariatric surgery. Removable, adjustable, and minimally invasive sounds good, right? Except the reality proved to be very different. Any food can trigger a race to the bathroom, but the most likely to do so is healthy food. Not only can bands make eating a nauseating experience, but it encourages unhealthy choices. So that’s why we do a lot of Lap Band-to-sleeve conversions.

Can you convert a gastric bypass to a sleeve?
In theory, yes, but in practice it just isn’t very beneficial. Which is unfortunate because a lot of bypass patients come to me wanting gastric sleeves. Why the no-go? Well, it’s very difficult to do that kind of conversion and practically useless to change a very complex procedure (bypass) to a much simple procedure (sleeve). Gastric bypass involves lots of cutting, rearranging, and reattaching of internal organs. In order to convert it to a sleeve, a surgeon would try to reattach the upper part of your stomach; detach your intestine, which has been connected to the upper part of your stomach; and then perform a sleeve. Yikes. There simply wouldn’t be enough benefit to involve all of that messing around again.

Can you convert a sleeve into any other bariatric weight loss tools?
Yep. The cool thing about the sleeve is that it can be revised—meaning, you can convert it into other types of bariatric solutions. As I just addressed above, you can’t go the other way, though. I don’t know why you’d want anything other than a sleeve (yes, I’m biased), but a gastric sleeve does give you options because, other than reshaping your stomach, it leaves your organs intact. The procedure to convert a sleeve into a bypass or duodenal switch is usually reserved for patients with very high BMIs. And I caution patients thinking of doing so to take a good, hard look at lifestyle choices that might be preventing them from losing weight with a sleeve.

Can I have my band removal and gastric sleeve surgeries done the same day?
Maybe. I understand why you’d want to do it in one procedure, but my top priority is always going to be your safety. That said, if we go in and see that the band is lying nicely and you have minimal scar tissue and adhesions, we can probably do the whole thing in one step. But if the band has been in too long or the original surgeon’s technique wasn’t great or there’s a lot of scar tissue or…you get the picture. There are many factors that can prevent the conversion being done in the same procedure as the band removal. Why can’t I go ahead? Because the stomach needs to rest and let the scar tissue heal a bit with no band in there provoking more inflammation. Then, after the stomach has been given a chance to reset for a few months, we can go back in and make a much cleaner, safer conversion to a sleeve.

Can I get a resleeve if I’ve already gotten a gastric sleeve?
Again, maybe. It depends in why you’re asking. If you had a good sleeve with an appropriate sized bougie but simply aren’t losing the last 20 or 30 pounds, chances are good that it’s not your sleeve’s fault. (Hint: You’re eating too many carbs, not exercising enough, or both.) In this case, your best bet is to go back to basics. Keep a food journal, commit to an exercise program, and make protein and veggies the basis of your diet. If I didn’t do your sleeve surgery, I can certainly talk to you about factors that may have resulted in a less-than-ideal sleeve. I also recommend that patients considering a resleeve get a barium sulfate solution test, complete with an endoscopy. After I’ve reviewed the results personally, I’ll have a better idea of whether you’re a candidate for resleeving. It’s not something to rush into, especially for the wrong reasons, and I turn a lot of patients down. But if you’re a good candidate, yes, resleeving is possible.

If you have more questions about conversions, please don’t hesitate to get in touch with our team at Endobariatric.

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“Changing lives…one sleeve at a time”.