Bariatric Surgery Tijuana Bariatric Center

Gastric Bypass: Why would someone regain weight after Gastric Bypass Surgery?

March 30, 2015 by Juan Antonio Lopez Corvala

If you are struggling with weight regain following a gastric bypass, you now have options.

Several studies suggest that the majority of patients regain significant weight after their initial gastric bypass.  Common causes include gradual stretching of the stomach pouch and outlet.  When the standard-of-care Roux-en-Y procedure is performed, the stomach and outlet are made very small which reduces the amount of food that can be consumed and slows the passage of food through the digestive tract.  Together, this helps people feel full after eating just a small amount of food.  With this dramatic decrease in calories, weight loss occurs.  Many clinicians have shown that when the stomach pouch and/or outlet gradually stretch, it takes longer for the patient to feel full, thus consuming more food. As a result, patients may begin to regain weight.

ANATOMICAL CHANGES CAN OCCUR OVER TIME.

Right when the gastric bypass surgery is performed, the outlet is left very small. Sometimes, a few years down the road, the outlet enlarges, allowing a larger intake of food, which makes the patient regain the weight.

ENDOSCOPIC OUTLET REPAIR PROCEDURE

With new technology, qualified patients now have access to an endoscopic procedure to reduce the volume of an enlarged pouch and outlet and return them to their original post-gastric bypass proportions. This procedure is performed using a small flexible endoscope and specialized devices that allow real sutures to be placed through the endoscope. The scope and suturing devices are inserted through the mouth into the stomach pouch the same way as a standard endoscope. Sutures are then placed around the outlet to reduce the diameter, typically to about 10mm. The same technique may then be used to place additional sutures in the stomach pouch to reduce its volume capacity.

WHAT ARE THE BENEFITS OF THE ENDOSCOPIC OUTLET REPAIR PROCEDURE?

With traditional revision surgery, scarring and adhesions from the initial gastric bypass procedure often make open or laparoscopic surgery very challenging. Abdominal revision surgery usually takes longer than the original gastric bypass and patients are three times more likely to develop complications.

With the endoscopic outlet repair procedure, patients:

•   Avoid the risks and complications of major abdominal surgery
•   Have less post-operative pain
•   Recover faster
•   Have no abdominal scars.

Typically, patients go home the same day, but each patient’s discharge will vary based on his/her physician’s recommendation.

WHAT ARE THE SIDE EFFECTS?

It is anticipated that patients will feel little or no discomfort from the endoscopic outlet repair procedure.  Minor side effects may include nausea, a temporary sore throat, swollen tongue, and lip pain from the insertion of the endoscope into the mouth.

WHAT IS THE RECOVERY PROCESS?

Typically, patients return to their normal routine within 48 hours. Following the endoscopic outlet repair procedure, patients should follow the same diet and exercise regimen they did after their initial bypass surgery.

WILL IT BE COVERED BY INSURANCE?

It depends upon the patient’s insurance plan.  For further information, please speak with your physician at your next appointment. Contact our office at (619) 730 0948 for a virtual consultation if you can not travel to Mexico for your own one-on-one consultation with Dr Lopez-Corvala. We will be glad to assist you.