Revisional surgery

The increase in the incidence of obesity in the world gave birth to bariatric surgery. This is a division of surgery that provides procedures geared towards helping patients lose weight. Revisional surgery refers to an operation that is done in patients who have already undergone a previous form of bariatric surgery. It is usually performed in the setting of complications or if the post surgery weight loss in not tallying with the expected. Complications that can prompt revisional surgery include development of fistulas, and ulcers, continuous vomiting and protein energy malnutrition. Reversal of a procedure can also be done if a patient loses too much weight. Options for revision are dependent on the primary procedure that was done, and some revision options are limited for some procedures. Recent surgical techniques offer more revision options compared to older techniques. Revisional surgeries are associated with greater risk for adverse outcome in the patient. Risk is highest in people who have lost too much weight and lowest in those who had minimal weight loss after the primary procedure.

Laparoscopic Inguinal Hernia Repair

Hernias that occur in the groin are known as inguinal hernias. These are characterized by small balloon-like pouches protruding from the groin region. These form at a natural point of weakness at the intersection of abdominal muscles. The protrusions occurs when a loop of intestine or fat passes through this weak point and either enters the inguinal canal or pushes out just medial (more in the middle) to the inguinal canal. Men usually suffer from inguinal hernias developing in the groin, and may notice an ambiguous discomfort or even a bulge in the scrotum. Infants and children also suffer from inguinal hernias when a part of the lining of the abdominal cavity called the peritoneum does not close properly. This leads to a bulge in the groin because the intestine or other abdominal contents may push into the opening when the pressures inside the abdomen rise.

Intestine herniating through direct inguinal hernia

What is the percentage of patients that gain their weight back?

A majority of patients will regain some weight after a bariatric surgical procedure. The amount regained ranges between a few pounds and all of the weight lost during the operation. The amount of weight regained after the operation is dependent on many factors and this is one of the reasons why so much stress and attention is made to the importance of a healthy lifestyle during the pre-op and post-surgical period.

For laparoscopic gastric bypass, long term weight loss after gastric bypass is suggested to be approximately 60-70% of your excess body weight at 2 years, and 45-50% of your excess

What are the possible side effects of bariatric surgery?

There are multiple side effects that can occur after laparoscopic gastric bypass or laparoscopic gastric sleeve.

Side effects include:
– Vomiting
– Dumping syndrome
– Nutritional deficiencies
– Gallstones
– Need to avoid pregnancy temporarily
– Nausea, vomiting, bloating, diarrhea, excessive sweating, increased gas, and dizziness

This is just a short list. Please speak with your surgeon regarding possibilities relating to your specific comorbidities.

Paraesophageal

The hiatus is a normal opening in the muscle that separates the chest cavity from the abdomen which moves up and down with breathing. Although the hiatus is a normal opening, there are occasions when this opening enlarges and the stomach or other organs can slip up inside the chest. This occasion of an abnormally large opening of the hiatus is called a hiatal hernia. Paraesophageal hernias account for only 5% of all hiatal hernias. A paraesophageal hernia is a type of hiatal hernia where the junction of the stomach and the esophagus remains in place, but part of the stomach is squeezed up into the chest beside the esophagus.