Are Bariatric Surgeries Eligible for Revision?

Michael Sutker, MD, PA Blog Are Bariatric Surgeries Eligible for Revision?
Are Bariatric Surgeries Eligible for Revision?

Getting bariatric surgery to lose weight and protect your health is a big decision. These weight loss procedures are extremely effective, but they also come with lasting side effects. For all intents and purposes, a bariatric surgery is not "reversible." It’s a good idea to explore all aspects of your procedure — including whether your surgery will be eligible for revision later on. 

At the private surgical practice of Michael Sutker, MD, PA, we offer different minimally invasive bariatric surgeries to help our patients in McKinney and Dallas, Texas shed extra pounds and reclaim their health. Dr. Sutker is always happy to answer any questions or concerns patients have. 

One question patients often raise is whether their bariatric surgery can be revised after the initial procedure. The answer is: It’s complicated. Keep reading to learn what you need to know.

Why would my bariatric surgery need revision?

Bariatric surgeries help you lose weight by changing your gastrointestinal system. Dr. Sutker offers several minimally invasive types of bariatric surgery, including sleeve gastrectomy and Roux-en-Y gastric bypass.

While these surgeries have a high success rate, they come with long-term side effects that can impact your lifestyle, such as a reduced appetite or smaller stomach. Some patients may find these side effects frustrating, particularly if they aren’t seeing the weight loss results they desired. In this case, a revision may be required. 

In addition, all surgeries come with risks — including bariatric surgery. Some patients find they develop more serious side effects or complications that necessitate additional surgery or make revision appealing, such as:

Keep in mind that thanks to advances in medicine and surgery, serious complications from bariatric surgery are rare. Most patients enjoy successful, long-term weight loss with bariatric surgery. 

Can my bariatric surgery be revised?

It’s best to consider bariatric surgery permanent. That being said, it is possible to revise some types of bariatric surgery. Here’s a look at some of the most common procedures and whether they’re revisable:

Gastric bypass

Gastric bypass, also called Roux-en-Y gastric bypass, is the most common type of bariatric surgery. It requires significant changes to your digestive system. During this surgery, your surgeon creates a small pouch, then reroutes your intestines to this new, smaller stomach. 

Revision is possible after gastric bypass surgery, but only when medically necessary. In select cases, your surgeon may convert your bypass to a duodenal switch (DS). The DS procedure is a combination of bypass and gastrectomy (removal of a portion of your stomach). 

It’s important to understand that this revision is a complex surgical procedure that comes with many risks. This is because your stomach and intestines must be divided and surgically put back together, but they can’t go back exactly as they were before. 

It’s also impossible for surgeons to repair the nerves that help with gastrointestinal function, which increases the risk of long-term complications, like reflux disease. As such, not all patients are eligible for this revision.

Sleeve gastrectomy

During this procedure, Dr. Sutker reduces the size of your stomach by creating a tube or “sleeve.” Since part of your stomach is removed, this type of surgery is not reversible. In some cases, however, Dr. Sutker may be able to revise a sleeve gastrectomy. 

A conversion from a sleeve to gastric bypass treats issues, such as reflux, and helps you keep losing weight. In fact, recent studies found 75% of patients suffering from reflux after sleeve gastrectomy no longer had symptoms after their revision.

A sleeve can also be easily converted to a duodenal switch, a procedure that is similar to a bypass but re-connects the intestines at a different portion. Patients with an extremely high BMI >60 or weight >400 lbs may actually have a "staged" weight loss procedure by first having a sleeve gastrectomy, losing 100-150 lbs, followed by conversion to a bypass or switch to lose additional weight.

Gastric band

This type of bariatric surgery is the easiest to revise. It’s possible to reverse gastric band surgery by removing or changing the location of the band, or deciding to opt for a sleeve gastrectomy or gastric bypass instead. 

Patients may opt for band removal if they don’t experience adequate weight loss or if they experience frustrating side effects. Revisional gastric band surgery can be performed laparoscopically, and is generally considered safe and effective. 

Dr. Sutker can also convert your band to a more aggressive weight loss solution, such as a Roux-en-Y gastric bypass. This may be a good option if you’re not seeing the weight loss results you want.

What else do I need to know about bariatric surgery revision?

It’s important to understand that depending on your original surgery, your digestive system might not function exactly the same as it did before the bariatric procedure. Revisions to gastric band surgeries are typically the safest and easiest.

It’s also important to know that if you’re interested in revisional weight loss surgery, you should first talk to a revision expert, like Dr. Sutker. When performing revisional bariatric surgery, Dr. Sutker uses the da Vinci® robotic surgical system, which gives him more control and precision. 

Have more questions about bariatric surgery or revision surgery? Request an appointment online or over the phone with Dr. Sutker at the location nearest you.

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