Surgical Pouch Revision

Gastric pouch and anastomotic revision are established revisions for bypass patients experiencing weight regain due to a stretched (dilated) pouch and/or due to the join between the pouch and bowel widening. The procedure involves reducing the size of the pouch and the gap between the stomach and the bowel (the stoma) to 1.5cm or less.

Studies indicate that this approach can deliver good weight loss in the 12 months after the revision procedure but that some weight is regained in the following 12-24 months. As such, longer term weight loss results are poor.

With regard to risk, this is one of the safer bypass revision procedures. A review of publications (by Tran et al published in Obesity Surgery 2016) showed a major complication rate of 3.5% only and zero mortality. Of course, the safety of the procedure needs to be balanced with what are modest weight loss outcomes.  The same study shows mean excess weight loss after 1 year of 43.3% but this figure dropped to 14% at 3 years. It should be said however that the outcomes vary significantly between studies. Due to the relatively poor weight loss outcomes we do not consider this an effective treatment as he weight loss barely warrants the surgical risk. At this time, we consider the other options to be more effective.

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