How Is An Endoscopic Revision Of Sleeve Gastrectomy Done?

Sleeve gastrectomy is the most popular bariatric surgery performed today and has helped many individuals achieve significant weight loss and improve their overall health. However, a number of these patients experience weight gain after their initial success.

Several factors can contribute to this dilemma, including lifestyle choices and physiological adaptations. Fortunately, advancements in medical technology have made it possible to address some of the underlying issues and stop weight gain through an endoscopic procedure without surgery.

Today we are going to discuss how a gastric sleeve revision is done to offer patients renewed hope and a second chance for sustainable weight loss.

Understanding Sleeve Gastrectomy Surgery

Sleeve gastrectomy, also referred to as gastric sleeve surgery, is a procedure where a significant portion of the stomach is removed to form a smaller, banana-shaped pouch. Typically, the surgeon removes about 75% of the stomach, and then the remainder of the stomach is surgically stapled along the edge to hold it together as it heals.

The purpose of this surgical procedure is to restrict the stomach’s capacity, which results in a decrease in the amount of food the individual can consume and helps them feel full more quickly. Patients must follow a very restricted diet for several weeks after the surgery, and recovery usually takes between four and six weeks.

Immediately after the surgery, it is common for patients to experience significant weight loss, improved metabolic health, and an enhanced quality of life.

Contributing Factors To Weight Regain After Gastric Sleeve

Despite the success of sleeve gastrectomy, some patients face challenges in maintaining long-term weight loss. Several factors can contribute to weight regain after the procedure, including:

Lifestyle Factors
Sometimes patients return to their previous eating habits and do not make choices that promote weight loss. A combination of lack of adherence to dietary guidelines and reduced physical activity can lead to increased caloric intake, hinder weight loss, or cause weight gain.
Stretching of the Stomach
Over time, the stomach pouch created during sleeve gastrectomy may stretch, allowing for a larger food intake and reducing the feeling of early satiety. This sometimes occurs because patients overeat during mealtimes, and as this continues, it takes more food to make them feel full, which could potentially result in increased caloric intake.
Physiological Adaptations
Our bodies are incredibly adaptable, and they can sometimes adjust to the changes that have been made to the stomach during a sleeve gastrectomy.

There may be changes in hormone levels that regulate appetite and hunger, which can influence food cravings and eating behaviors.

Additionally, the body’s metabolism can adapt to reduced caloric intake, slowing down to preserve energy, which may impact the rate of weight loss or result in weight gain.

What Is A Gastric Sleeve Revision?

A gastric sleeve revision can be done to address weight gain after some bariatric surgeries. It can be performed using a technique called endoscopic sleeve gastroplasty (ESG), which is a minimally invasive procedure used to modify and reshape the stomach after a previous sleeve gastrectomy or gastric bypass surgery.

ESG is performed endoscopically, meaning it is conducted through the mouth and esophagus without the need for any external incisions.

Because the procedure does not require surgery or incisions, there are significantly fewer risks than those associated with surgery. Most patients report little to no pain and typically resume their normal activities within a few days.

Endoscopic Revision: Dr. Batash Explains What It Is & Illustrates How It Works

Today we are going to discuss how a gastric sleeve revision is done to offer patients renewed hope and a 2nd chance for sustainable weight loss.

How Is A Gastric Sleeve Revision Done?

A gastric sleeve revision typically involves the following steps:

  • The patient is placed under conscious sedation or general anesthesia to ensure their comfort during the procedure;
  • The gastroenterologist inserts a flexible endoscope through the patient’s mouth and down the esophagus to reach the stomach;
  • Using specialized endoscopic instruments, the doctor places a series of sutures or stitches within the stomach to manipulate and reduce its usable capacity and length. When these stitches have been placed, the stomach resembles a sleeve-like structure;
  • Once the desired alterations are made, the endoscope is withdrawn, and the procedure is completed.

The gastric sleeve revision procedure restores the restrictive effect of the original gastric sleeve surgery and promotes a sense of fullness when consuming smaller food portions.

ReSculpt endoscopic revision of gastric sleeve

Are You A Good Candidate For A Gastric Sleeve Revision?

Not all patients who experience weight regain after sleeve gastrectomy are suitable candidates for endoscopic procedures. Eligibility for an endoscopic gastric sleeve revision is determined on an individual basis, considering various factors.

You may not be a suitable candidate if you have had certain previous gastrointestinal surgeries, issues with the anatomy of your stomach, a serious medical condition, are pregnant or breastfeeding, etc.

What Is The Key Contributor To The Success Of A Gastric Sleeve Revision Done Through Endoscopy?

After the completion of the revision, the patient and their actions are the primary contributors to how successful their weight loss results will be.
Endoscopic revision procedures can be an effective tool to enhance or restart weight loss after previous gastric sleeve surgery, but they must be combined with lifestyle changes or they will not be effective in the long term.

Patients can experience weight regain several years after undergoing bariatric surgery, and this is usually attributed to the patient or the bariatric program rather than the surgery itself. When the patient fails to achieve adequate weight loss, it typically occurs for one of two reasons:

  • The bariatric program did not provide the education and support the patient needed and may be responsible for the lack of these services.
  • The patient did not make any changes to their lifestyle despite being provided with education and support.

It is critical that patients continue to follow a balanced diet, exercise regularly, and participate in behavioral counseling if necessary to support sustainable weight management after undergoing an endoscopic revision sleeve gastrectomy.

Where Can I Get Help With Weight Regain After Gastric Sleeve?

Gaining weight after losing a significant amount through a surgical sleeve gastrectomy can be a frustrating setback. However, there are now endoscopic procedures that can effectively tighten the stomach and aid in lasting weight loss outcomes.

At Batash Endoscopic Weight Loss Center, the combination of a personalized treatment plan and the patient’s commitment to healthier lifestyle choices can result in sustainable weight loss. We can restore the effectiveness of your original surgery and help get you back on track.

If you are experiencing weight regain after having gastric sleeve surgery, set up a consultation with Dr. Steven Batash in NYC. He will work with you to come up with the most appropriate course of action to address your concerns while considering your specific needs and goals.

An endoscopic revision to a sleeve gastrectomy may be just the second chance you need to restore your health and boost your self-confidence. Do not wait until your situation becomes much worse, make your appointment today. We would love to help!

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