Gastric Bypass And Gastric Sleeve Revision

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Some patients that undergo bariatric surgery will see a tremendous weight loss and possibly remission of weight-related illness. They are able to maintain their new lifestyle and are successful in maintaining their weight. However, other bariatric weight loss patients may experience weight regain despite their best efforts.

Why Does Weight Regain Happen After Bariatric Surgery?

Statistics show that about half of the patients who undergo bariatric surgery gain back some of the weight they have lost within the first two years. There are many reasons that this may happen and not all of them are within the control of the patient.

Illustration: Weight Regain After Bariatric Surgery
Illustration: Weight Regain After Bariatric Surgery

Reasons Patients May Regain Weight After Bariatric Surgery

A patient’s metabolism may work against them as they are trying to lose weight. When they eat less to try to lose weight, their body slows down their metabolism to help them conserve energy by burning fewer calories.

Sometimes the bariatric surgery performed was not the best fit for the patient.
Patients can overeat just enough to stretch out their stomach pouch gradually making it bigger allowing them to continue eating too much during mealtime.

Anatomical changes can occur that inhibit bariatric surgery by limiting the amount of food that can be ingested. The most common is the enlargement of the gastrojejunal stoma (the connection between the stomach and small intestine).

Sometimes the procedure performed causes chronic negative side effects, such as severe acid reflux, causing a patient to seek a revision.
Life happens and patients fall back into counter-productive habits that lead to weight regain.
Stress produces the hormone cortisol which encourages the body to hold on to excess fat. Managing stress is essential in facilitating weight loss and curbing weight regain.

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What Can Be Done About Weight Regain?

Despite best efforts, a patient may experience weight regain and It is best to address this issue before it gets too far out of hand.

Bariatric surgeons recommend that their patients keep the lines of communication open and reach out if they need help or have concerns. They are there to support their patients and do not want them feeling overwhelmed or discouraged because they are gaining weight despite the circumstances.

The issues that cause patients to regain weight or prevent them from losing weight can often be corrected with a bariatric revision or a conversion from one type of surgery to another. The sooner implemented, the quicker the patient’s weight loss gets back on track.

What Is A Bariatric Revision?

A bariatric revision is a procedure used to enhance or correct the original weight loss procedure or surgery you had. There are both surgical and non-surgical options for a weight loss revision. A consultation with the bariatric surgeon will help determine the best technique to use to get you back on track. The type of procedure you had previously, your current BMI, and overall health will be factors in choosing the best fit for you.

Gastric Bypass Revision Options

Gastric bypass surgery can be converted into a different type of bariatric surgery or can be revised to fix any issues that may be preventing further weight loss or allowing weight regain.

Illustration: Gastric Bypass Revision
Illustration: Gastric Bypass Revision

What is the best revision surgery for gastric bypass?

The procedure that will work best will depend on the unique circumstances of each patient based on factors such as why the previous surgery did not result in the desired outcome, etc.

1. Transoral Outlet Reduction (TORe)

TORe also known as an OverStitch procedure is a non-surgical procedure that is performed to revise a previously performed gastric bypass to help patients who are experiencing weight regain. TORe is done using an endoscope so there are no incisions or a hospital stay involved. The endoscope, which is a thin flexible tube that is inserted down the throat, is used to access the gastric outlet which is the opening between the gastric pouch (the new smaller stomach) and the small intestine.

Using the OverStitch™ endoscopic suturing system, the surgeon places a series of small sutures to close the gastric outlet and make it a bit smaller. This will cause the patient to feel full faster and help them lose weight.

The transoral outlet reduction procedure is done as an outpatient procedure and does not require any time in the hospital. The recovery time is normally just a few days.

2. Sclerotherapy

Sclerotherapy is a non-surgical procedure that is performed endoscopically to shrink the stomach pouch or the size of the connection between the stomach pouch and the small intestine which can sometimes stretch out over time allowing more food to be ingested by the patient and no longer providing the feeling of being” full” for an adequate length of time.

The surgeon lowers the endoscope down the patient’s throat and another special tool and administers an injection or series of injections (normally sodium morrhuate) in strategic locations to reduce the size or capacity of the stomach pouch or opening to it.

The patient is no longer able to eat as much as they feel “full” longer which helps them lose weight.

3. Duodenal Switch Surgery

Duodenal switch is a surgical procedure that is used to make the stomach smaller and also alters 2 portions of the digestive system so the body can not absorb as many calories. Patients who previously had gastric bypass surgery can be converted to a duodenal switch, however, the surgery is complex and poses more risks than undergoing the duodenal switch surgery initially.

Take the first step on your journey to a healthy life

IBI Healthcare Institute provides an unmatched patient experience and outstanding results. You matter to us.

Gastric Sleeve Revision Options

Gastric sleeve revision or GSRE is done to make the stomach size smaller. sometimes a patient’s stomach stretches out and allows for the consumption of too many calories which causes them to gain weight. A gastric sleeve revision can effectively correct this situation. It is also possible for the patient to undergo a surgical conversion to change their gastric sleeve surgery into a different form of bariatric surgery which is known as gastric sleeve revision surgery.

Illustration: Gastric Sleeve Revision
Illustration: Gastric Sleeve Revision

What is the Gastric Sleeve Revision Success Rate?

One of the most popular revisions of gastric sleeve surgery is the gastric sleeve revision to bypass. Approximately 80-90% of patients who undergo gastric sleeve revision surgery achieve their weight loss goals initially but only about 70% are likely to maintain their weight loss long-term. Some of the reasons the success rate decreases may be due to age, overall health, and lack of patient dedication.

1. Non-surgical Gastric Sleeve Revision (GSRE)

GSRE is a non-surgical procedure that is performed endoscopically to adjust the size of the sleeve, originally the stomach but reduced to a sleeve-like pouch during the initial gastric sleeve surgery. The surgeon accesses the pouch via the patient’s throat and similar to the technique used during the endoscopic sleeve gastroplasty, sutures the pouch in strategic locations to become smaller. This will restore the pouch to its pre-stretched size or make it a bit smaller.

3. Gastric Sleeve in Sleeve (SIS)

Gastric sleeve in sleeve (SIS) is a non-surgical plication procedure that is performed through an endoscope. It restores the tightness of the sleeve to its pre-stretched size using a series of folds and sutures in the pouch creating a sleeve of decreased volume.

4. Gastric Sleeve Surgical Conversions

Gastric sleeve surgery can also be converted to other types of bariatric surgery to stop weight regain or effect additional weight loss. Gastric sleeve surgery can be converted to gastric bypass surgery or duodenal switch surgery.

Bariatric Revision Diet Plan

These dietary guidelines will provide you with the hydration and nutrition your body requires before and after a bariatric revisional procedure.

Download pdf

Download the updated manufacturer’s dietary guidebook for the ESG, Balloons, GSRe, and TORe procedures: the English version and the Spanish version.

How Much Does Bariatric Revision Cost?

The cost of a bariatric revision will vary depending on the type of revision or conversion being performed and which procedure you had previously.

The cost of a gastric sleeve or gastric bypass revision not only includes the price of the procedure but the expertise and skill of the surgeon or specialist that is performing it. Finding a qualified professional with vast experience in executing the procedure you are having done is critical to obtaining desired results.

Visit the IBI Healthcare Institute pricing page to learn more.

Bariatric Revision Can Help Stop Weight Regain

Although bariatric surgery has a high rate of success, there are some instances where patients find themselves experiencing weight regain or at a permanent plateau. Whatever is causing their previous weight loss procedure to no longer be effective, a bariatric revision procedure or surgery can help.

Where Can I Find Gastric Bypass Revision Surgery Near Me?

It can be concerning to regain the weight you have lost after bariatric surgery. If you are experiencing weight regain, you are not alone and there is help! Contact IBI Healthcare Institute today and do not let the situation escalate. One of the IBI Healthcare Institute’s caring experts can help you formulate a plan to get you back on track.

Take the first step on your journey to a healthy life

IBI Healthcare Institute provides an unmatched patient experience and outstanding results. You matter to us.

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