Category: Failed gastric bypass
Gastro-gastric fistula after gastric bypass operation
May 10, 2013 9:09 pm
One of the complications of gastric bypass is a gastro gastric fistula. This happens when a connection between the gastric bypass pouch develops to the remnant stomach. In a gastric bypass operation, a very small pouch is created from the stomach, and connected to a segment of the small bowel.
The purpose of this operation is to decrease over 95% of the volume of the stomach. In theory, the benefits of this is to reduce the volume of food that can be consumed. Over time, the size of the stomach pouch, and/or size of the gastro-jejunostomy anastomosis might stretch. This result in weight regain that is very commonly seen in about 3 years after a gastric bypass operation.
One of the complications of gastric bypass is a gastro gastric fistula. This happens when a connection between the gastric bypass pouch develops to the remnant stomach. In a gastric bypass operation, a very small pouch is created from the stomach, and connected to a segment of the small bowel.
The purpose of this operation is to decrease over 95% of the volume of the stomach. In theory, the benefits of this is to reduce the volume of food that can be consumed. Over time, the size of the stomach pouch, and/or size of the gastro-jejunostomy anastomosis might stretch. This result in weight regain that is very commonly seen in about 3 years after a gastric bypass operation.
Another possible explanation for weight regain may be an abnormal connection that may develop over time between the bypassed stomach and the small pouch that was created. This abnormal connection is known as a gastro-gastric fistula. In a patient who may have a gastro-gastric fistula, the food can travel down the gastric bypass path or enter the bypassed stomach and go down the path of a normal anatomy.
In these cases, the physiological effect of a gastric bypass procedure becomes ineffective.
The treatment that I favor most for correcting the complication of the gastro-gastric fistula is is to revise the gastric bypass to the duodenal switch operation.
Feeding Jejunostomy TubeExclusive Member Content
February 06, 2012 3:38 am
Yearly lab and medication requests
October 17, 2011 5:28 pm
First, we now have preferred laboratories that have partnered with us. The laboratory results are expected to be sent to us electronically, which should cut down on the time between the blood draw and when the results are available to us. The information on the preferred labs is located at: https://www.dssurgery.com/lab. Needless to say, there are no financial incentives for us. You should also check with one of the labs, as well as with your insurance company, to make sure that they are a contracted facility and that the order is covered under your policy. It is your responsibility to make sure that your insurance company will pay for the labs ordered. We are in no way responsible for the verification of benefits for the laboratory services that we order.
Second, we have had to change the way we order our yearly lab work. As most of you are aware, it is critical that weight loss surgical patients have continuous yearly follow-up care and monitoring. It is critical that the patients continue to receive yearly follow-up care, not only by doing their scheduled laboratory studies, but also by a yearly follow up in office exam. We provide a comprehensive follow-up plan to the patients who have had the the Duodenal Switch or Revision from other failed weight loss surgical procedures. This includes ordering the laboratory studies, review and interpretation of the results, as well as office visits as frequently as required or deemed necessary.
Obesityhelp.com revision Forum information
November 08, 2009 9:00 am
I am not sure what has happened over the past two weeks or so, but I have received a number of inquiries from patients who have had questions about the revision of RNY or Lap Band® for weight regain, inadequate weight loss, or other complications. I finally had to ask one of the patients where he got his information and heard about our practice. His source of information was the obesityhelp.com website.
I have spent some time looking over and responding to several postings on the forum sites. I have referred to a number of publications in some of my postings on obsityhelp.com.
Nishie et.al. (Obesity Surgery, 17, 2007 1183-1188) reported:
“Pouch size area, measured by routine UGI on the first postoperative day does not influence short term postoperative weight loss. “
Cottam et.al. (Obesity Surgery 2009, 19:13-17) concluded:
“The level of restriction or the presence of stenosis achieved by different stapler sizes does not have a significant role in weight loss.”
O’Connor et.al. (Surgery for Obesity and Related Dis. 4(2008) 399-403) summarizes:
“With construction of divided, vertical, lesser curvature based small-volume (less than or equal to 20 cm gastric pouches, the actual size of the gastric pouch did not correlate with the %EWL at 1 year laparoscopic GB.”
I am a firm believer that the best patient is the most knowledgeable patient. It is always safer to spend as much time as needed to ask questions and investigate all options. If I can provide any information, please contact us at contact@dssurgery.com
Get informed
September 26, 2009 6:56 pm