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2019 Expert Consensus Panel Report On Revisional Surgery For Weight Regain Or Type 2 Diabetes

Posted on: 31st Jan, 2020

Most people lose a large amount of weight and keep it off long term, but a significant number of people will regain weight in the years after metabolic surgery. Others will simply not lose adequate amounts of weight or not completely reverse their type 2 diabetes, often due to genetic factors, or simply because of starting at a very high BMI. Today, there are excellent options to revise the surgery that succeed in causing large and significant weight loss and reversal of type 2 diabetes, hypertension, sleep apnea and other health conditions.
 
A recent expert consensus panel publication offered conclusions from centers around the world. The good news is that increasing reports demonstrate safe, effective, laparoscopic revisional procedures that carry a high rate of long term success in creating profound weight loss, if weight regain has occurred following a past bariatric procedure.
 
The panel concluded that:
 
  • Duodenal Switch (or Biliopancreatic Diversion or SADI) carries the highest success rate following a sleeve procedure.
  • Roux en Y gastric bypass is the most effective for resolving gastroesophageal reflux (GERD)
  • Reoperations are safe and effective
 
Our center has one of the largest series in North America of Duodenal Switch procedures as a 2nd stage following sleeve gastrectomy, with outstanding results.
 
The American Diabetes Association now recommends metabolic surgery for all patients with Type 2 diabetes and a BMI over 35.
 
These long-term benefits come without the side effects of a bypass surgical procedure. In over 2,200 consecutive laparoscopic sleeve gastrectomy procedure, Dr. Sasse has had 0.0% mortality, and in the past 1,700 consecutive sleeve procedures over 5 years running, there has been 0.0% rate of the major complication of leak.
 
“Bariatric surgery’s metabolic effect persists and is more effective at treating type 2 diabetes in moderate and severely obese patients when compared to medical therapy.”
         – Dr. Sangeeta Kashyap, MD, Endocrinologist, The Cleveland Clinic.
* Rodríguez, J., Zerrweck, C., Inzunza, E.A., Urbina, D., Palomares, C. and Vizcarra, R., 2016. Laparoscopic sleeve gastrectomy: results at 10 years. Surgery for Obesity and Related Diseases, 12(7), pp.S8-S9.
 

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