Bariatric Revision Surgery: When and Why it may be Necessary

Bariatric surgery has proven to be a life-changing procedure for many individuals struggling with severe obesity. However, in some cases, patients may require additional surgical interventions, known as bariatric revision surgery, to address certain complications or optimize the outcomes of their initial weight loss surgery. In this article, we will delve into the reasons why bariatric revision surgery may be necessary, explore the different types of revision surgeries available, and discuss the insurance requirements for undergoing such procedures.

Understanding the Need for Bariatric Revision Surgery:

While bariatric surgery can yield remarkable results, it is important to acknowledge that not every procedure will achieve the desired long-term weight loss goals for all patients. Several factors may contribute to the need for bariatric revision surgery:

  • Inadequate Weight Loss: Sometimes, patients do not achieve sufficient weight loss following their initial bariatric surgery due to metabolic changes, lifestyle factors, or anatomical issues that require further intervention.
  • Weight Regain: In certain cases, individuals may experience weight regain after an initial successful weight loss following bariatric surgery. This can occur due to various factors, including dietary habits, hormonal changes, or insufficient long-term lifestyle modifications.
  • Surgical Complications: Although bariatric surgery is generally safe, complications can occur. These may include postoperative complications like leaks, strictures, or ulcers, or long-term complications such as hernias, band slippage, or erosion.
  • Nutritional Deficiencies: Some patients may develop nutritional deficiencies, such as vitamin or mineral deficiencies, following their primary bariatric procedure. Revision surgery may be necessary to address these deficiencies and optimize long-term health.

Types of Bariatric Revision Surgeries:

When considering revision surgery, there are several options available depending on the patient’s initial procedure and specific needs. Here are a few common types of bariatric revision surgeries:

  • Vertical Sleeve Gastrectomy Revision: A sleeve revision may involve reducing the size of the stomach to restore restriction and limit food intake. If the stomach pouch has become dilated or stretched, a sleeve revision surgery may involve reshaping the stomach to restore its size and capacity.
  • Roux-en-Y Gastric Bypass Revision: Gastric bypass revision may be necessary if the stomach pouch or the stoma (the connection between the stomach pouch and the small intestine) has stretched or widened. A gastric bypass revision surgery may involve resizing or narrowing these areas to restore restriction and limit food intake.  A gastric bypass revision surgery may also involve lengthening or adjusting the Roux limb to modify the digestive process and enhance weight loss. The Roux limb is the section of the small intestine that is connected to the stomach pouch.
  • Conversion to Roux-en-Y Gastric Bypass: Conversion to gastric bypass involves altering the anatomy of the stomach and intestines to create a smaller stomach pouch and reroute the digestive tract. It may be recommended for patients who have experienced inadequate weight loss or weight regain after gastric banding or vertical sleeve gastrectomy.
  • Gastric Band Removal and Conversion: For patients who have undergone adjustable gastric banding, but have experienced complications or unsatisfactory weight loss, removal of the band and conversion to another procedure, such as gastric bypass or sleeve gastrectomy, may be recommended.

Insurance Requirements for Bariatric Revision Surgery:

Insurance coverage for bariatric revision surgery can vary depending on the insurance provider and policy. It is essential to consult with your insurance company to understand their specific requirements. Generally, the following factors may influence insurance coverage:

  • Medical Necessity: Insurance providers typically require documented medical evidence showing that the revision surgery is necessary to address complications or significant weight regain.
  • Physician Recommendation: A bariatric surgeon’s recommendation and supporting documentation are crucial to demonstrate the medical necessity of revision surgery.
  • Preauthorization: It is important to obtain preauthorization from your insurance provider before undergoing any bariatric revision surgery. This involves submitting the necessary medical documentation and meeting specific criteria established by the insurance company.

Conclusion:

Bariatric revision surgery can be an effective solution for individuals who face challenges or complications following their initial bariatric procedure. Whether it’s inadequate weight loss, weight regain, surgical complications, or nutritional deficiencies, revision surgeries offer hope for patients to improve their long-term outcomes. However, it is important to note that each case is unique, and the decision for revision surgery should be made in consultation with an experienced bariatric surgeon. Understanding the insurance requirements and working closely with your healthcare team will help navigate the financial aspects of bariatric revision surgery.

Understanding the Risks of Living with Morbid Obesity

Morbid obesity is a serious health condition that affects millions of individuals worldwide. It significantly increases the risk of various life-threatening diseases and reduces overall quality of life. Bariatric surgery offers a potential solution to combat this condition and improve health outcomes. However, it’s crucial for prospective patients to understand the risks associated with living with morbid obesity if they choose not to undergo bariatric surgery. This article aims to shed light on these risks and help individuals make informed decisions about their health. Read more

The Cost-Effectiveness of Bariatric Surgery: Transforming Lives and Finances

For individuals struggling with severe obesity, the decision to undergo bariatric surgery is a life-changing one. Not only does it offer significant health benefits, but it also has the potential to be a cost-effective solution in the long run. While the upfront costs of bariatric surgery may seem daunting, it is essential to recognize the substantial financial benefits it can bring over time. In this article, we will explore why self-pay bariatric surgery candidates should consider the cost-effectiveness of this transformative procedure. Read more

Weight Loss Surgery: A Promising Solution for Diabetes

Diabetes is a chronic condition that affects millions of people worldwide. It is a condition that results in high levels of blood sugar, leading to a range of complications such as heart disease, kidney failure, blindness, and amputations. While traditional treatments like medications and lifestyle changes can help manage diabetes, weight loss surgery is a promising solution that can help resolve the condition altogether. Read more

What is the Success Rate for Bariatric Surgery?

The success rate of bariatric surgery, also known as weight loss surgery, can vary depending on the type of procedure, the patient’s health status, and other factors. Generally, weight loss surgery is considered successful if the patient achieves and maintains a significant reduction in body weight and experiences improvement in obesity-related health conditions.

Here are some general success rates for the most common types of weight loss surgery:

  • Gastric bypass surgery: Studies have shown that gastric bypass surgery can result in weight loss of 60-80% of excess body weight within the first year after surgery. Long-term success rates (10 years or more) have been reported to be around 50-60%.
  • Sleeve gastrectomy: Sleeve gastrectomy is a procedure that involves removing a large portion of the stomach to create a smaller, tube-shaped stomach. Studies have shown that sleeve gastrectomy can result in weight loss of 50-70% of excess body weight within the first year after surgery. Long-term success rates are still being studied.
  • Laparoscopic adjustable gastric banding: This procedure involves placing a band around the upper part of the stomach to create a small pouch. Studies have shown that laparoscopic adjustable gastric banding can result in weight loss of 40-50% of excess body weight within the first year after surgery. Long-term success rates (10 years or more) have been reported to be around 30%.

It’s important to note that weight loss surgery is not a guarantee of success, and patients must commit to making long-term lifestyle changes to achieve and maintain their weight loss goals. Working with a healthcare team, including a dietitian and mental health professional, can also improve the chances of success.

For more information, call 973-410-9700 or contact us online.

Horizon BCBS NJ Updates Bariatric Surgery Criteria to Include Patients with BMI Over 30 and Type 2 Diabetes

Horizon Blue Cross Blue Shield of New Jersey recently updated their bariatric coverage policy to include members with a BMI > 30 with a comorbidity of Type 2 Diabetes. Read more

Keto diets could increase risk of stroke and heart attack, new study suggests.

Researchers say low-carb, high-fat ‘keto-like’ diets lead to higher ‘bad’ cholesterol, which raises risk of stroke and heart disease.

In recent years, the “keto diet” (low-carb ketogenic) has increased in popularity among those looking to lose weight.

However, a new study suggests that a “keto-like” diet could set off an increase in “bad” cholesterol, which can lead to a buildup of plaque in the arteries and a significantly greater risk of heart attacks, strokes and other cardiovascular events.

Findings from the study were presented on Sunday in New Orleans, Louisiana, at the American College of Cardiology’s Annual Scientific Session Together With the World Congress of Cardiology.

In a press release about the findings, lead author Iulia Iatan, M.D., PhD, says “Our study found that regular consumption of a self-reported diet low in carbohydrates and high in fat was associated with increased levels of LDL cholesterol — or ‘bad’ cholesterol — and a higher risk of heart disease.”

According to the American Heart Association, bariatric surgery may lower the risk of future cardiovascular problems.

A recent study demonstrated that participants with cardiovascular disease and severe obesity (a body mass index of 40 or higher) who underwent bariatric surgery had fewer major cardiovascular events than people with similar conditions who did not have the surgery. Fewer of them died as well.

To learn more about bariatric surgery in New Jersey, please call 973-410-9700 or contact us online.

Alexander Abkin, MD, FACS, FASMBS

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Dr. Alexander Abkin has been voted as a NJ Top Doc by New Jersey Monthly magazine for a 16th consecutive year (since 2007). Read more

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New guidelines for weight loss surgery were announced by the American Society for Metabolic and Bariatric Surgery (ASMBS) and the International Federation for the Surgery of Obesity and Metabolic Disorders (IFSO), the first in more than 30 years. Read more

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Joel Katz speaks with Dr. Aram Jawed about the many benefits of minimally invasive Bariatric surgery. Read more