When is Bariatric Revision Surgery necessary?


Revisional bariatric surgery is performed to alter or repair a preexisting operation for treatment of obesity. With the increasing number of surgical procedures performed, the need for revise/repair operations is also rising.

There are two main indicators for revision surgery following previous weight loss surgery. One indicator revolves around weight loss and weight gain—too much too fast can be dangerous, not enough over time or actually regaining weight following the original procedure keeps patients from attaining the health benefits of successful weight loss.

The second indicator involves developing complications that are related to the original procedure, such as ulcers following RY gastric bypass and slippage or tissue erosion following Lap Band. In these situations, a follow-up bariatric procedure, known as a bariatric surgery revision, may be necessary to alter or repair the initial bariatric surgery.

Obesity is a chronic disease and not easily treated. If initial weight loss surgical treatment is not effective bariatric revision surgery may be necessary as an additional treatment for obesity. The two most popular bariatric procedures performed today, gastric bypass surgery and Lap Band surgery, are considered very successful weight loss procedures overall. As stated above, in some cases, revisions are necessary due to either insufficient weight loss or surgical complications.

Estimates are that five to fifteen percent of people who have had gastric bypass surgery start regaining weight within three to five years. Perhaps as many as 25 percent of lap band patients experience complications or discouraging discomfort following surgery It is expected that the amount of bariatric revisions will continue to increase simply because of the fact that the total amount of bariatric surgeries performed is increasing as well.

Revisions After LAP BAND Surgery

The revision rate for the Lap Band surgery is approximately 10% during the first two years due to either device-related problems or unsatisfactory weight loss. Slippage of the gastric band, a complication specific to this type of surgery, requires a follow up procedure to fix the problem. Patients have the option of replacing the band or choosing to revise to another procedure.

Revisions After Gastric Bypass Surgery

A gastric bypass revision is necessary in approximately 5 to 10% of patients over 5 years due to unsatisfactory weight loss, weight regain or complications such as ulcers, chronic vomiting, hernia, staple line failure, that can often be improved through revisional bariatric surgery. If gastric bypass fails, patients need to maintain exercise and food intake and support efforts while exploring surgical options including placement of an adjustable gastric band on the stomach pouch, conversion to distal gastric bypass, and conversion to duodenal switch.

Patient Criteria for Revisional Bariatric Surgery

Before a revisional bariatric procedure is performed, the patient will be examined by the bariatric surgeon to determine the cause of failure and to evaluate the appropriate treatment options. Bariatric surgery is a very specialized and complicated treatment process that doctors approach carefully. Great care is given to maximizing weight loss success while minimizing risks and complications. Your surgeon will discuss the options and what each patient should expect with the bariatric revision.

Results with a Bariatric Revision

Although the results can vary widely depending on the original procedure and the reason for the revision, bariatric surgery revisions are usually successful in resolving the associated problems and promoting further weight loss. Weight loss following a revision is usually not as dramatic as the initial bariatric procedure, but it can be substantial over time.

As revision surgery can be more complex and involve more risks than general bariatric surgery, it is important to choose a bariatric surgeon that is experienced and skilled in performing revision bariatric surgery and that the operation is performed at a medical facility that is designated as a Bariatric Surgery Center of Excellence by The American Society for Metabolic and Bariatric Surgery

As with all bariatric procedures, the best weight loss results are achieved by patients who are able to comply with the diet and exercise recommendations of their bariatric surgeon. The post-bariatric process can be a struggle and patients will benefit in their weight loss efforts by attending support groups, talking to a nutritionist for dietary advice, working out with a bariatric exercise program, and if needed, talking to a psychologist to help deal with emotional aspect of obesity and weight loss surgery.

Potential Complications

Any major surgery involves the potential for complications—adverse events that increase risk, hospital stay and mortality. Some complications are common to all abdominal operations while some are specific to bariatric surgery. A person who chooses to undergo bariatric surgery should know about these risks.

Learn more about the potential complications of abdominal and bariatric surgery.