Bariatric surgery has improved greatly in recent years. The specialisation of the surgeons who are dedicated to it has made our results much better. Unfortunately, we are receiving more and more frequently patients who, having been operated on many years ago with old techniques or less recently in inexperienced centres, have gained weight again.
The failure of a bariatric surgery can be due to many causes, some attributable to the change of life and diet and others, the most frequent, to the surgical technique used. For example, a gastric by-pass made with an uncalibrated stomach outlet channel will cause, in the long term, a dilation of the intestine and finally an increase in weight.
These situations can be solved thanks to current tools such as gastric band placement over gastric or biliopancreatic bypass or as the Apollo endoscopic suture method that allows low-risk methods to correct the problem.
Causes of weight regain after gastric bypass and how to correct them:
| Cause | Correction |
|---|---|
| Gastric reservoir dilation | Band over by pass |
| Exit channel expansion | Endoscopic Apollo Suture |
| Gastric reserve fistula | Endoscopic closure with Apollo |
Causes of weight regain after biliopancreatic by-pass (Scopinaro) and how to correct them:
| Cause | Correction |
|---|---|
| Excessive carbohydrate intake | Band on Scopinaro |
| Incorrect measurements of the small intestine | Correction by surgery |
Causes of weight regain after tubular gastroplasty or sleeve gastrectomy and how to correct them:
| Cause | Correction |
|---|---|
| Incorrectly calibrated tube in surgery | Re tubulization |
| Gastric tubular dilation | Re tubulization |
Obesity
SurgeryApollo Method
It is a suture that is applied endoscopically, that is, reaching the digestive tract through the mouth. With this method we can give points in various areas of the digestive tract such as the gastric reservoir or the outlet channel between the stomach and the intestine in an old by-pass and modify them. We can reduce the stomach or its output to regain satiety, reduce the volume of food we eat and lose weight again.
Band Over By Pass
When there has been a dilation of the gastric reservoir after a bypass or an excessive intake of solid carbohydrates is occurring after a Scopinaro, an adjustable gastric band can be placed, which in the same way will again cause an early feeling of satiety.
We must not forget that cases of weight gain after obesity surgery are tremendously individual and before proposing any technique it is necessary to make a correct prior assessment, with tests such as contrast transit or endoscopy, in order to propose the most appropriate method of correction.
