Sleeve International Federation For The Surgery Of Obesity
Failure of Sleeve, (not sufficient weight loss or weight regained) after sleeve is unavoidable. Just pass 5 years since Sleeve as a stay along surgery had been performed the first statistical data are showing that failure rate after this surgery can be quite high. As a restrictive surgery results would depend on BMI before surgery. Patient with a sleeve with a BMI above 50 or even 45 may not do well. Problems with Laparoscopic sleeve are related to calibration (volume) of the sleeve, which is not measured during the surgery and component of stretching what happened after this operation. According to recent data Duodenal Switch is the most successful revisional surgery for sleeve. Revision to RYGB doesn’t have any sense because is reversing the best restrictive procedure (sleeve) to completely unpredictable gastric by-pass. Adding band on sleeve goes with all possible complications related to Lap.Band. The only logical option is revision to Duodenal switch which can give patient a chance to loose 90% of excess weight with a BMI close to 24.
Data from International Federation For The Obesity Surgery meeting Istanbul 2013