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Endoscopic Revision Treatment

Endoscopic Revision is a solution for those facing complications after undergoing bariatric surgeries like gastric bypass or sleeve gastrectomy. This minimally invasive technique provides a more comfortable and quicker recovery. If you are noticing weight regain or other issues post-bariatric surgery, reach out to Pristyn Care. Our bariatric surgeons are available to consult and guide you through the best possible solutions. Don't let the weight weigh you down. Book an appointment with Pristyn Care now.

Endoscopic Revision is a solution for those facing complications after undergoing bariatric surgeries ... Read More

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What is Endoscopic Revision?

Endoscopic Revision is a medical procedure for treating complications or suboptimal outcomes from previous bariatric surgeries, such as gastric bypass or sleeve gastrectomy. This minimally invasive approach uses an endoscope and a flexible tube with a camera, offering the surgeon an internal view of the stomach without the need for external incisions.

Endoscopic Revision is needed when patients experience issues like weight regain due to a stretched gastric sleeve or pouch. The procedure is performed by specialists in gastroenterology or bariatric surgery who are trained in endoscopic techniques.

One significant advantage of this treatment is its reduced recovery time. Additionally, it presents lower risks of complications compared to traditional surgery and has proven successful in promptly and safely restoring effective weight loss mechanisms.

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Types Of Endoscopic-Revision

Endoscopic Revision encompasses several techniques, each designed to correct or improve outcomes from previous bariatric surgeries. The key types of Endoscopic Revisions include:

  • Revision Endoscopic Gastroplasty (R-EG): This technique reshapes the stomach to enhance weight loss and counteract weight regains.
  • Endoscopic Sleeve Gastroplasty (ESG): A technique that reduces the size of the stomach by using sutures, thereby mimicking results similar to traditional sleeve gastrectomy.
  • Endoscopic Gastric Bypass Revision: This procedure modifies the existing gastric bypass to enhance weight loss outcomes, often employing methods like plication.
  • Intragastric Balloon Placement: This technique involves placing a balloon inside the stomach to promote satiety and facilitate weight loss. It is often used as a temporary measure.

These different types present patients with less invasive options for revising previous surgeries, offering benefits such as shortened recovery periods and reduced risks compared to traditional surgical revisions.

Diagnosis Before Endoscopic Revision Procedure

Before considering the Endoscopic Revision procedure, it is crucial to identify the specific issues that call for the procedure. Various diagnostic methods are used to evaluate the condition of the stomach and the effectiveness of previous bariatric surgeries. These include:

  • Endoscopy: This is a common diagnostic tool where a flexible endoscope is inserted through your mouth into your stomach. This process allows doctors to visually inspect your stomach and identify issues like dilation of the gastric pouch or stoma.
  • Imaging Studies: Techniques such as X-rays or ultrasounds may be employed to assess the anatomy of your stomach and any complications arising post-procedure.
  • Patient History and Physical Examination: Your doctor will seek detailed information about your weight loss journey, dietary habits, and any symptoms experienced after the procedure. This helps understand the need for Revision.
  • Nutritional Assessment: A thorough evaluation of your nutritional status can provide insight into potential deficiencies or complications resulting from previous surgeries.

By employing these diagnostic methods, doctors ensure that the Endoscopic Revision is tailored to your specific needs, increasing the probability of a successful outcome.

Procedure For Endoscopic Revision

The Endoscopic Revision procedure is a minimally invasive technique aimed at correcting complications or suboptimal outcomes from previous bariatric surgeries. The process involves:

  • Anaesthesia: You’ll be administered general anaesthesia to ensure comfort and prevent pain during the procedure.
  • Endoscope Insertion: A flexible endoscope will be carefully inserted through your mouth and into your stomach. The endoscope comes with a camera that allows your surgeon to view internal structures on a monitor.
  • Identification of Issues: Your surgeon will examine your stomach using the endoscopic camera to identify problems such as a stretched gastric sleeve or pouch.
  • Repair or Modification: Depending on the specific Endoscopic Revision technique, specialised tools inserted through the endoscope may be used to repair or modify your stomach, such as placing sutures to reduce the size of the stomach or stomach outlet.
  • Suture Placement: Using endoscopic tools, sutures are strategically placed to tighten and repair stretched-out areas, effectively restoring the restrictive environment.
  • Completion: Once the necessary repairs or modifications have been made, the endoscope is carefully removed. You’ll then be transferred to a recovery area.

The entire procedure typically takes 30 to 45 minutes, and you can usually return to work within two to three days after the operation.

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Who Is The Right Candidate For Endoscopic Revision?

Determining the right candidate for Endoscopic Revision is essential for ensuring a successful outcome and minimising potential risks. Here are some essential factors considered when assessing a patient’s eligibility:

  • Body Mass Index (BMI): A BMI of 30 or higher is generally recommended for Endoscopic Revision procedures like Endoscopic Sleeve Gastroplasty (ESG).
  • Previous weight loss attempts: Endoscopic Revision is usually suggested for individuals who have tried other weight loss methods without success.
  • Medical history: Certain medical conditions like severe GERD, Barrett’s oesophagus, or a history of gastric surgery may make you ineligible for Endoscopic Revision.
  • Surgical history: If you have a history of gastric surgery, you may not be a suitable candidate for an Endoscopic Revision procedure as previous operations may cause scar tissue on your stomach, increasing risk.
  • Current health status: Conditions like heart disease, diabetes, history of stroke, or the use of blood thinners will be evaluated before considering you for an Endoscopic Revision procedure.
  • Lifestyle habits: Habits such as smoking or excessive alcohol consumption can influence your eligibility for the Endoscopic Revision procedure.
  • Commitment to a healthier lifestyle: It is crucial to be strongly dedicated to achieving substantial dietary and lifestyle changes. While the procedure aids weight loss, it requires significant changes for it to be effective.

Your doctor will decide whether to proceed with Endoscopic Revision, taking into account your unique health status and needs.

Benefits Of Endoscopic Revision

Endoscopic Revision has emerged as an effective solution for individuals contending with weight regain after bariatric surgery. This minimally invasive procedure addresses complications from previous surgeries and reinstates the efficacy of weight loss mechanisms. Key benefits include:

  • Minimally Invasive: This approach, carried out through the mouth using an endoscope, eliminates external incisions, thus preventing visible scarring.
  • Reduced Risk of Complications: As compared to traditional surgical revisions, Endoscopic Revision carries a significantly lower risk of major complications.
  • Shorter Recovery Time: Most patients can return home on the same day of the procedure and resume normal activities within two to three days.
  • Minimal Postoperative Pain: Endoscopic Revision typically results in less post-procedure pain and discomfort compared to other surgical revisions.
  • Outpatient Procedure: This is an outpatient procedure, which means patients do not need an overnight hospital stay.
  • Improved Weight Loss Potential: Endoscopic Revision helps reestablish the restrictive environment of the stomach, leading to renewed weight loss.
  • Cure for Dumping Syndrome: This procedure can alleviate symptoms of dumping syndrome in patients who have undergone gastric bypass.

How To Prepare For Endoscopic-Revision?

Proper preparation is important for a successful Endoscopic Revision procedure. Here are some measures you can take:

  • Consultation with the Surgeon: Discuss your medical history, previous surgeries, and concerns about weight regain with your surgeon.
  • Preoperative Testing: Undergo any required preoperative tests to evaluate your overall health.
  • Dietary Modifications: Follow dietary guidelines provided by your healthcare team before the procedure.
  • Medication Review: Review your current medications with your healthcare provider. Some may need to be adjusted or temporarily discontinued.
  • Smoking Cessation: If you smoke, quit at least a few weeks before the procedure.
  • Arrange for Support: Ensure that someone is available to drive you home and assist during recovery.
  • Follow Preoperative Instructions: Adhere to all specific instructions given by your healthcare provider, including fasting requirements.

Recovery Tips and Precautions To Follow After Endoscopic Revision

Recovery Post-Endoscopic Revision is crucial for the success of the procedure. Here are some tips to enhance your healing process:

  • Hydration: Stay well-hydrated by drinking plenty of fluids, preferably water.
  • Gradual Diet Progression: Begin with clear liquids, then slowly transition to a soft diet as tolerated.
  • Avoid Strenuous Activities: Refrain from heavy lifting and strenuous activities for at least two weeks post-procedure.
  • Follow-Up Appointments: Ensure you attend all follow-up appointments with your healthcare provider.
  • Pain Management: To manage discomfort, use prescribed pain medications as directed. Consult your doctor before taking any new over-the-counter medications.
  • Monitor for Complications: Be vigilant for signs of complications such as severe abdominal pain, persistent nausea, vomiting, or fever.
  • Lifestyle Changes: Commit to healthier lifestyle changes, including a balanced diet and regular physical activity.

Potential Risks Or Complications Associated With Endoscopic Revision

While Endoscopic Revision is generally safe, there are potential risks and complications to be aware of:

  • Bleeding: This is one of the most common complications that can occur during or after the procedure.
  • Anastomotic Leaks: These leaks can occur at surgical connections made during the procedure and can lead to severe infections.
  • Strictures: Narrowing of the stomach or connections created during the procedure can occur, leading to difficulty swallowing.
  • Infection: Like any surgical procedure, there’s a risk of infection at the site of intervention.
  • Nutritional Deficiencies: Post-surgery, patients may experience difficulties in nutrient absorption leading to deficiencies.
  • Weight Regain: Despite the procedure’s goal to enhance weight loss, some patients may still experience weight regain if lifestyle changes are not adequately implemented.
  • Gastrointestinal Symptoms: After the procedure, patients may experience nausea, vomiting, or abdominal discomfort. Persistent issues may require further evaluation and management.

What Is The Cost Of Endoscopic Revision In India?

In India, the cost of an Endoscopic Revision procedure can vary due to number of factors.

Several factors influence this cost:

  • Type of Procedure: Different Endoscopic Revision techniques have distinct costs. For example, the price range for a Revision Endoscopic Gastroplasty (R-EG) might not be the same as that for an Endoscopic Sleeve Gastroplasty (ESG).
  • Surgeon’s Experience: Surgeons with a high level of expertise and reputation may have higher charges.
  • Hospital Reputation: Choosing a renowned or specialised hospital can increase the overall cost compared to smaller, less specialised healthcare facilities.
  • Location: Healthcare costs can fluctuate based on the city or region in India. Metropolitan areas like Delhi, Mumbai, or Bangalore typically have higher costs than smaller cities.
  • Anaesthesia and Medications: The type of anaesthesia used and medications prescribed during and after the operation can contribute to the overall cost.
  • Preoperative and Postoperative Care: Preoperative tests, consultations, postoperative care, and follow-ups are often included in the overall cost.
  • Health Insurance: Health insurance coverage can partially or fully cover the cost of Endoscopic Revision. It is advisable to confirm the coverage details with your insurance provider.
  • Additional Services: Services like physical therapy and rehabilitation or assistive devices required after the procedure can add to the expense.
  • Medical Tourism Packages: International patients sometimes choose packages that include surgery, accommodation, transportation, etc., which can impact overall costs.
  • Exchange Rates: For international patients, costs may vary due to exchange rate fluctuations.

Please note that healthcare costs can change over time, so always consult with your healthcare provider or do thorough research for the most current information.

Is Endoscopic Revision Covered Under Insurance?

Endoscopic Revision procedures are not uniformly covered by insurance providers. Occasionally, patients with specific cases, particularly for revisions of previous bariatric surgeries, have managed to get insurance coverage. However, this process is often complicated.

Normally, patients pay for the procedure upfront and later seek reimbursement from their insurance company. This is not always guaranteed as Endoscopic Revision, despite its FDA approval and proven effectiveness, is still a relatively new technique. As the Endoscopic Revision procedure becomes more recognised and additional data becomes available, insurance coverage for Endoscopic Revision is likely to improve in the future.

In conclusion, endoscopic revision represents a promising solution for individuals seeking to improve their weight loss outcomes after bariatric surgery. As the field continues to evolve, ongoing research and clinical experience will further enhance the effectiveness and safety of Endoscopic Revision, offering hope to those struggling with the long-term effects of previous bariatric procedures.

Frequently Asked Questions

What causes the need for an Endoscopic Revision?

Endoscopic Revision is often necessitated due to complications from a previous endoscopic surgery. These complications can include infection, bleeding, poor healing or the recurrence of the original medical condition that first warranted an endoscopic treatment.

How will my doctor diagnose if I need an Endoscopic Revision?

Your doctor could use various diagnostic procedures, such as imaging tests (such as an MRI or CT scan), laboratory tests, and sometimes even an exploratory endoscopy, to determine if you require an Endoscopic Revision.

What's the typical success rate of Endoscopic Revisions in India?

The success rate of Endoscopic Revisions is largely dependent on the complexity of the individual case, as well as the experience and proficiency of the operating doctor. Generally, it is high in India due to advancements in medical technology and skilled professionals.

Can lifestyle changes affect my recovery after an Endoscopic Revision?

Absolutely! Healthy lifestyle changes are essential for speedy recovery after an Endoscopic Revision. These can include a balanced diet, regular exercise within comfort levels, avoiding strenuous activities, maintaining a healthy weight, and abstaining from smoking or alcohol consumption.

What's the usual recovery time following an Endoscopic Revision?

The recovery period for an Endoscopic Revision can vary based on the severity of your condition, your overall health, and how well you follow post-procedure care instructions. Typically, one might expect a recovery period of a few weeks to several months.

Will my visits to the OPD increase after an Endoscopic Revision?

Your visits to the OPD might increase temporarily after an Endoscopic Revision. These visits allow your doctor to monitor your healing process closely and make necessary adjustments in your treatment plan if needed.

Does the treatment for the root cause differ from that of an Endoscopic Revision?

The treatment for the root cause and that of an Endoscopic Revision are closely linked yet may differ. While the root cause treatment primarily works towards resolving the underlying condition, an Endoscopic Revision focuses on rectifying complications arising from prior endoscopic surgery.

Are there alternative treatments for Endoscopic Revision?

Alternatives to Endoscopic Revision are based on the specific complications from your previous endoscopy. Therefore, it’s essential to have a detailed discussion with your doctor about all possible alternative treatments and their repercussions.

How can I boost my chances of a successful Endoscopic Revision?

Following your doctor’s pre-and post-operative instructions diligently, maintaining a healthy lifestyle, and attending all your follow-up appointments can significantly enhance your chances of a successful Endoscopic Revision.

What factors can impact the success rate of my Endoscopic Revision?

Several factors could impact the success rate of your Endoscopic Revision, including your overall health condition, age, lifestyle habits, severity of complications from previous endoscopies, and even the expertise of the operating doctor.

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