WHAT IS REVISION SURGERY?

Nowadays, we have started to hear about revision surgeries more frequently after obesity surgeries. The revision comes from English "revision". The Turkish equivalent of revision surgeries can be translated as correction and adjustment operations. As the name suggests, an operation must be performed first, and the operation must either be unsuccessful or inadequate or cause a complication. In these cases, if the operation is re-operated for correction or adjustment, revision surgery is called in the general name of these surgeries.

Revision surgeries don't just describe a surgery. Since the problem will be different in every patient, revision surgeries are also different from each other. It is very important for what the patient should have a revision surgery and what kind of treatment plan the physician will make in the face of this problem and operate the patient. Because revision surgeries are more difficult, more complicated and technically more risky than the first surgery. These are the initiatives in which the physician's experience comes to the fore. Because an attempt has been made to cut or completely change the original structure before, and therefore the anatomy is different from what is known. On the other hand, severe adhesions have occurred due to the previous surgery, and these adhesions always appear as a problem, even a risk, during revision surgery. Adhesions can change the location of mobile organs such as the intestines. During the surgery, the surgeon may not be able to reach the area to be operated due to adhesions, and sometimes adhesions may be so high that the surgeon may not be able to recognize the organ. Procedures to separate these adhesions from each other may cause organ injury. Therefore, it is very, very important for the physician to be experienced.

        REQUIREMENTS TO KNOW THE CAUSES OF FAILURE BEFORE REVISION SURGERY

Another important stage of revision surgeries is how the revision will be performed. It is difficult to accurately decide what surgery will be performed on a patient who has previously undergone tube gastric surgery but could not lose enough weight after surgery or gained weight again. The surgeon, patient and even patient relatives should get together before the operation and find answers to the following questions:

• Why did the patient not reach sufficient or target weight?
• Is there a problem with the surgical technique in the first surgery?
• Who was the first surgeon who performed the operation and what was his experience?
• How much weight did the patient lose and how much did he regain?
• How has the patient's eating habits and eating habits changed after the first surgery and how is his eating habits now?
• Was the weight not lost or regained due to a problem such as alcohol or carbohydrate intake?
• Was the patient on a good diet program after surgery? If so, did the patient apply them regularly?
• Was the patient included in the sports program and did the patient apply them?
• Does the patient have psychological problems? Does he use medication?
• Does the patient have a hormonal disorder that will cause failure after the first surgery?
• Was a correct obesity surgery performed on the patient in the first surgery?
• What is the current volume of the stomach and does the stomach fundus stand?
• Has the intestines been intervened in the previous surgery?

These questions should be increased according to the patient and the reasons should be revealed. After determining all the reasons, it will be possible to reach the correct surgical method that will solve the problem. Therefore, we can compare revision surgeries to a game of chess. Making the right move will bring success.

In revision surgeries, the subject is so wide and the questions are so many that why revision surgeries are needed, why the first surgery is inadequate, where mistakes are made, who are required for revision surgeries, what are the risks and what can be done to solve them, I will tell you section by section.