Revision Bariatric Surgery

Revisional Bariatric Surgery for Weight Regain

Weight regain after bariatric surgery can be shocking; however, in most cases, it is perfectly normal and can be easily managed. Over the course of a couple of years, our patients will lose a significant amount of weight, very quickly. This is a result of substantial dietary, exercise, and lifestyle modifications, as well as restricted food intake. This restriction may be combined with a modification of the small intestine if the patient has a gastric bypass or a duodenal switch. This significant weight loss, of course, can only last for a limited time, and patients will eventually plateau. The exact time it takes for their weight to stabilize will also depend on the extent of the patient’s lifestyle changes and the procedure they have undergone.

Once the weight stabilizes, the patient’s lifestyle will have normalized, and many changes will begin to occur in the body. One of these changes may involve stretching the smaller stomach pouch if the patient liberalizes their diet and consumes more food. This means that patients may regain 5-10% of their excess body weight after stabilization.

Revising a Gastric Band

Most commonly, however, we revise the gastric band or Lap-Band because of relatively higher long-term complication rates. One of the original selling points of the gastric band — its reversibility — is helpful, as we can easily revise the procedure to a gastric sleeve or a gastric bypass. Since no part of the gastrointestinal tract is altered during the gastric band procedure, follow-up is relatively straightforward.

>Revising a Gastric Band

Revising a Gastric Bypass or a Gastric Sleeve

Revising the gastric bypass or gastric sleeve is slightly more challenging and comes with a higher risk than the primary bariatric procedure. While we perform these revisions regularly, they are less common because patients typically maintain excellent weight loss and disease improvement over the longer term.

If your weight gain is mild or significant, you must contact us to identify the root cause and learn how to manage the risk of weight regain in the future.

When We Consider Revision Surgery

When patients come to our office worried about this type of weight gain, we usually evaluate their exercise and diet regimen and suggest ways to manage their weight more effectively. This may include consuming denser proteins that will keep them fuller longer, eating smaller portions more often, or consuming fewer high-sugar and high-fat foods.

If the weight gain is significant, or if there are wild fluctuations in weight, it may be a sign of unacceptable stretching of the stomach pouch; or, in gastric bypass patients, enlarging of the stoma – the opening from the stomach to the small intestine. In cases where the stomach has stretched too much or the stoma is not functioning properly, relatively straightforward revision procedures are available to correct the issues. These are usually performed on an outpatient basis and return the stomach and/or the stoma to their original post-surgery size and effectiveness.