Bariatric Revision Surgery: When Revision is Necessary?

Bariatric Revision Surgery

It is not uncommon for patients who have had bariatric surgery to relapse and regain weight. Statistics show that one in five people who undergo weight loss surgery regain weight within the first several years. Today we will be talking about bariatric revision surgery.

One would think that reducing the size of the stomach through weight loss surgery would ensure that the results are permanent. Unfortunately, it is not that easy and is a bit more complicated than that. Individuals can gain weight after bariatric surgery due to various factors, and sometimes the surgery itself does not truly meet the patient’s needs. To understand why we should take a look at how weight loss surgery works.

What is Bariatric Surgery?

Bariatric surgery alters the digestive tract temporarily or permanently, controlling the amount of food a person can ingest at one time, limiting the number of calories absorbed, and aiding in hunger control. This surgical procedure assists patients in losing weight.

Individuals who have a body mass index (BMI) of 40+ qualify for bariatric surgeries or procedures. Also, if a patient has a BMI of 35+ and has a weight-related health issue like type 2 diabetes, they would be a candidate for weight loss surgery.

Gaining Weight after Bariatric Surgery

Usually, patients who have bariatric surgery will see significant weight loss in the first several months. Much of this can be attributed to the smaller stomach size, the body having to heal from surgery, and the very restricted diet patients must follow. The human metabolism can speed up or slow down adapting to change as part of the body’s natural preservation ability.

Bariatric surgery can have complications, such as stomach stretching or individuals overeating. If these issues occur, the benefits of the surgery may be ineffective, leading to weight regain. Patients often seek bariatric revision surgery to address these complications and facilitate weight loss.

Revision of Previous Weight Loss Surgery

Revisional weight loss surgery can repair areas that were altered during a previous bariatric procedure but have stretched out.

Bariatric surgeries make the stomach smaller to limit food intake and promote weight loss. However, overeating or natural healing can stretch the stomach pouch. Weight loss revision surgery can fix this issue and restore the original restrictive properties of the procedure.

What is Bariatric Revision Surgery?

Many people ask “Can you have bariatric surgery twice?”.  If you have previously had bariatric weight loss surgery and have regained weight, finding diet and exercise are ineffective, you may be a candidate for bariatric revision surgery. Bariatric revision surgery would help correct any issues that have occurred since the initial surgery which are inhibiting further weight loss.

After bariatric surgery, patients continue to receive care from their surgeon for several years. Depending on the time that has passed since the procedure, the surgeon may still be monitoring progress and determining if a revision is necessary. This may involve X-rays to assess stomach size and identify any issues with weight loss.

It may have been years since the initial surgery and you may have gained weight for a variety of reasons. Depending on the type of surgery you had initially, you may benefit from revision surgery. The revision options that would work best for you are going to depend upon your weight loss goals and the type of surgery you had previously.

Gastric Sleeve Revision Surgery

If you had previous Gastric Sleeve Surgery and need a revision, you can opt for a technique called Endoscopic Sleeve Gastroplasty (ESG). During this procedure, the doctor accesses the stomach through the throat endoscopically, making it an outpatient procedure. The revision of the gastric sleeve is performed by suturing to reduce the size of the stomach, eliminating the need for incisions or a hospital stay.

Gastric Bypass Revision Surgery

If you have previously undergone Gastric Bypass Surgery and require a revision the procedure is called a Transoral Gastric Outlet Reduction (TORe) and is used to repair or reconfigure the connection that links the stomach and small bowel.

Sometimes the surgeon can insert some sutures into the gastric outlet using an endoscope using zero incisions. After these stitches have been put in, patients get full faster so they stop eating and lose weight.

A gastric bypass revision performed endoscopically is an outpatient procedure and individuals can go home the same day with a fairly short recovery time.

Bariatric Revision Surgery FAQs

1. How Do They Do Weight Loss Revision Surgery?

Individuals who have either gained weight after bariatric surgery or whose weight loss has stalled despite their perseverance in their diet and exercise program sometimes need some help to initiate additional weight loss. There are a few different techniques surgeons can use to help these patients including:

  • Reducing the size of the connection between your stomach pouch and small intestine.

  • Further reducing the stomach size. This can usually be done using sutures endoscopically and does not require incisions.

  • Converting your surgery to a different type of procedure for example the gastric sleeve to a gastric bypass or a gastric bypass to a duodenal switch.

  • The surgeon tightens or resizes the stretched-out stomach pouch. They achieve this by using sutures or by administering endoscopic injections of sclerosant containing sodium correlate, which causes the stomach to shrink.

2. How Do You Qualify?

If you want to know if you can have bariatric revision surgery, make an appointment to talk to your surgeon. They will look at things like if you are suitable for the surgery:

  • Patient’s overall health and unique circumstances.

  • The type of weight loss surgery that is being revised.

  • The reasons for insufficient weight loss or causes of weight gain.

  • If complications from the initial surgery are the reason for revision.

  • In some cases, patients may need to provide psychological and nutritional assessment results.

3. How Many Weight Loss Surgeries Can a Person Have?

How many times a person can have a bariatric weight loss procedure is decided based on their specific circumstances. Consultation with a surgeon is necessary to determine if additional surgery is possible.

  • Choosing a skilled bariatric specialist and the right procedure from the start will reduce the need for future surgery revisions.

  • Commitment to permanent lifestyle changes is necessary for success, regardless of the type of weight loss procedure chosen.

4. Is Weight Loss Slower after Revision?

Patients will lose weight at their rate; however, patients who have had revision surgery have reported that they lost weight at a slower rate after revision surgery than they did after their initial procedure. Patients have the potential to lose up to about 60 percent of their excess body weight after the revision.

5. How Long is Bariatric Revision Surgery?

The length of the revision procedure depends on the type of change being done. For instance, converting a gastric sleeve to a gastric bypass will take about 2.5 hours. Additionally, repairing staple failure on a sleeve normally takes between 30 to 60 minutes.

6. How Successful is Bariatric Revision Surgery?

Bariatric revision surgery typically yields positive results, alleviating heartburn, and acid reflux, and promoting substantial weight loss. Moreover, this procedure often leads to solving health issues caused by obesity.

Patients typically lose about 60 pounds for every 100 pounds they have in excess weight. To figure out excess weight, you subtract the weight you want to be from the weight you currently are.

7. Is Gastric Bypass Revision Safe?

Firstly, the risks of gastric bypass revision vary by procedure and technique. Additionally, we advise patients to follow postoperative care instructions and avoid undergoing a second surgery. Regardless, discover safe weight loss surgery options and find the right procedure for you. Contact IBI Healthcare Institute for a personal consultation with our bariatric experts to learn more about bariatric revision surgery.

Picture of Dr. A. Christopher Ibikunle MD FACS
Dr. A. Christopher Ibikunle MD FACS
Dr A. Christopher Ibikunle (MD, FACS) is a distinguished surgeon with a rich academic and clinical background. After completing his residency at the Cleveland Clinic Foundation, he served as an Active Staff and Assistant Professor of Surgery. Currently, he is a Professor of Surgery at Augusta University/University of Georgia Medical Partnership and a Lead Preceptor for several institutions, including Morehouse University and Philadelphia College of Osteopathic Medicine. Dr. Chris is a fellow of the American College of Surgeons and a member of the American Society for Metabolic and Bariatric Surgery, committed to advancing surgery and patient care.
Be part of our community, and let’s share positivity, insights, and healthy living tips!

Related Posts