Re-sleeve gastrectomy
Potential benefits
Restores restriction in patients with a dilated sleeve; preserves a sleeve-type anatomy; typically lower nutritional impact than a malabsorptive conversion.
Considerations and risks
Staple-line risk on previously operated tissue; does not address reflux; may not be appropriate when GERD is a primary concern.
Candidacy
Selected patients with a clearly dilated sleeve, no significant reflux, and no severe metabolic disease requiring more aggressive intervention.
Mini gastric bypass (OAGB)
Potential benefits
Single anastomosis with a long, narrow gastric tube; strong metabolic effect; often substantial additional weight loss.
Considerations and risks
Bile reflux is a known consideration; nutritional follow-up is essential; not appropriate for every anatomy.
Candidacy
Selected patients seeking a strong metabolic and weight-loss effect who can commit to long-term follow-up and supplementation.
Roux-en-Y gastric bypass
Potential benefits
Established conversion for sleeve patients with significant reflux; meaningful metabolic effect; long published track record.
Considerations and risks
Two anastomoses; risk of internal hernia, marginal ulcer, and dumping; requires lifelong supplementation and follow-up.
Candidacy
Patients with severe reflux after sleeve, regain with metabolic concerns, or anatomic reasons favoring RYGB.
Sleeve Rescue Plus
Potential benefits
A program-defined approach combining sleeve revision with additional measures to address regain or inadequate loss.
Considerations and risks
As with any revision, complexity and risk depend on prior anatomy and individual factors.
Candidacy
Patients evaluated as suitable for sleeve-based revision within the program's specific criteria.
Diabetes Magna Plus
Potential benefits
A program-defined metabolic procedure designed to maximize diabetes remission potential in selected revision candidates.
Considerations and risks
Higher metabolic and nutritional complexity; requires committed long-term follow-up.
Candidacy
Patients with type 2 diabetes recurrence or persistent metabolic disease meeting program-specific criteria.
Important limitations
Comparison categories are intentionally general. Determining the appropriate option requires individual evaluation including imaging, endoscopy, laboratory studies, and review of medical history.