Revisional Bariatric Surgery


Revisional bariatric surgery is another term for follow-up weight loss surgery.

Who Needs Revisional Bariatric Surgery?

Patients may need revisional bariatric surgery for the following reasons:

  • The patient isn’t meeting their weight loss goals and is still overweight.
  • The patient has regained weight after initial weight loss.
  • The patient underwent gastric band surgery and needs the band adjusted or replaced.
  • The patient underwent Roux-en-Y gastric bypass surgery and the tiny stomach pouch created in the original operation has stretched and become too large. The second procedure will make the stomach smaller to restrict eating or the physician may shorten the small intestine segment that absorbs calories.
  • The patient underwent a sleeve gastrectomy and the sleeve or banana-shaped stomach formed in the original surgery has stretched. The second procedure may be done if the patient needs to lose more weight.
  • The patient has developed an ulcer or hiatal hernia.

How to Prepare For Surgery

To determine if a patient is a candidate for revisional bariatric surgery, the bariatric team will thoroughly evaluate the problems the patient is experiencing. The patient will receive detailed instructions to follow before surgery, depending on the type of revisional bariatric surgery they will be undergoing.

Gastric Sleeve Revision Surgery

If the patient has previously undergone gastric sleeve surgery and requires a revision, the second procedure can be performed through a technique called endoscopic sleeve gastroplasty (ESG). The physician uses an endoscope to access the stomach via the throat. The procedure is done through sutures that reduce the stomach size without having to make incisions in the abdomen.


Gastric Bypass Revision Surgery

If the patient has previously undergone gastric bypass surgery and needs a revision, the second procedure is called a transoral gastric outlet reduction. The goal of the operation is to repair or reconfigure the connection that links the stomach and small bowel.

In some cases, the surgeon is able to use an endoscope to make sutures in the gastric outlet. If the gastric bypass revision is performed endoscopically, then it’s done on an outpatient basis.

What to Expect During Weight Loss Revision Surgery

Depending on the type of bariatric surgery that was initially done, the surgeon may use one of the following techniques to perform revision surgery:

  • Reducing the stomach size using sutures placed endoscopically.
  • Tightening or resizing a stomach pouch that has become stretched; done using sutures or injections of sclerosant containing sodium morrhuate.
  • Reducing the size of the connection between the stomach pouch and small intestine.
  • Converting the initial surgery to a different type of procedure; for example turning the gastric sleeve into a gastric bypass, or a gastric bypass into a duodenal switch.

After Surgery

After revisional surgery, patients will need to adjust once again to a new diet and lifestyle. Our team of registered dietitians provide support with meal planning and vitamin and mineral supplements.

In addition, our fitness experts help the patient maintain an active lifestyle to ensure the excess weight stays off.

Contact our office today to learn more and schedule an appointment.