Revisional bariatric surgery may be done for a variety of reasons. If the initial surgery did not bring the desired results or led to complications, patients may need a second surgery.
A physician may recommend a second procedure if the patient isn’t reaching their weight loss and remains obese. Patients who have regained a significant amount of the weight they’ve lost after surgery may also need revisional bariatric surgery.
The following complications and medical conditions may also necessitate bariatric revision:
- After gastric band surgery, the patient’s band may slip or fail to inflate properly. Patients may need a second surgery to adjust or replace the band.
- After a Roux-en-Y gastric bypass surgery, the patient’s stomach pouch can overstretch. A second surgery may be necessary to make the stomach smaller and restrict eating, or to shorten the small intestine segment that absorbs calories.
- After a sleeve gastrectomy, the patient’s sleeve or banana-shaped stomach may stretch, and they may need to undergo a second bariatric surgery to continue weight loss.
- After the initial surgery, patients who develop an ulcer or hiatal hernia may need revisional bariatric surgery.
How to Prepare For Revisional Bariatric Surgery
Before revisional bariatric surgery, our bariatric team will evaluate the patient to identify potential underlying causes for medical complications.
Be sure to ask your provider the following questions:
- How do I prepare for revisional bariatric surgery?
- What happens during the recovery process?
- When can I resume normal activities?
- How much weight should I expect to lose after the second surgery?
- When will I start seeing weight loss results?
- What lifestyle changes will I need to make after the second surgery?
Surgery Options
Depending on the patient’s unique condition and the initial type of surgery that was performed, they may benefit from one of the following types of revisional bariatric surgery options.
- Transoral Outlet Reduction (TORe): The Transoral Outlet Reduction (TORe) addresses weight gain after gastric bypass. The goal of TORe is to reduce the size of the gastric pouch so that the patient eats less food and feels full sooner. Patients can expect the procedure to take anywhere from 30 to 90 minutes. They will be able to return home the same day, but will need one to three days before they can return to work.
- Sclerotherapy: Some patients may benefit from an injection of a sclerosant (sodium morrhuate) into the stoma, which is the opening between the stomach and small intestine to address stoma dilation. The injections are typically done over the course of two or three procedures and help create scarring that reduces the size of the stoma.
- Lap Band Surgery: Patients undergoing Lap Band surgery as revisional bariatric surgery may expect the procedure, health benefits, costs, and potential complications to be similar to having lap band surgery as an initial procedure.
- Duodenal Switch Surgery: Patients who were morbidly obese prior to gastric bypass surgery (50+ BMI) may benefit from a duodenal switch surgery. Patients should speak to their physician to find out which type of revisional bariatric surgery is best for them.
