What are revision bariatric surgeries?
They are procedures performed on patients who have a history of previous bariatric surgery in order to improve their outcomes due to insufficient weight loss, weight regain, or the presence of a complication such as severe gastroesophageal reflux with esophagitis that affects the patient’s quality of life.
The most common revisional surgeries are conversions from one bariatric surgery to another.
For example, the conversion from a gastric sleeve to a Gastric Bypass. It is important to note that this second surgery does not result in significant weight loss, and revisional surgery is associated with a higher rate of complications compared to primary bariatric surgeries.
The recovery from revisional surgery is quite quick and straightforward. On the day of surgery, in the immediate postoperative period, the patient can walk and start oral intake with a liquid diet.
In the case of revision surgery, the patient stays hospitalized for two nights and is discharged on the second day. As part of the postoperative protocol, an intra-abdominal drainage is placed to diagnose bleeding or poor internal healing early. It is removed on an outpatient basis between days 5 and 6 post-surgery.
No special care is required for this type of surgery; only the following is recommended: cleaning the wounds with water and soap, avoiding strenuous activities, staying active at home, and strictly following the nutritional recommendations given by the nutrition team.
Between the fourth and fifth days after surgery, the patient can return to their city of origin (for non-residents of Cartagena de Indias) or resume their daily activities, including work, except for activities involving physical exertion.
The patient is discharged with three medications: pain relievers, antacids, and an anticoagulant. All patients require lifelong supplements of proteins, vitamins, and minerals to maintain nutritional health.
Regarding physical activity and sports, it is recommended to engage in brisk walks for one hour, five times a week, after fifteen days. At thirty days, resistance and strength exercises should be initiated.
Regarding the diet, it starts immediately after surgery with clear liquids for three days, followed by a liquid diet for an additional week, and a soft diet for approximately ten days. An estimated forty days post-surgery, the patient can transition to a solid diet under the guidance of the nutrition team.
What are the complications of revision surgery?
Complications of revision surgeries are very rare. Patients may experience intraabdominal or abdominal wall bleeding or infection, gastric fistulas, or strictures.
They may also encounter pulmonary embolism, blood clots in the blood vessels of the lower or abdominal extremities, mucus plug in the lungs, allergies, and so on. All these complications are preventable if clear protocols for bariatric patient management are applied, if the surgery is performed in optimal clinics, and if it is carried out by specialized surgeons.
