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What You Need to Know About Weight Loss Surgery Revisions and Reversals

Bariatric surgery team in operating room performs a revision to a bariatric procedure

Many times, patients who have had bariatric surgery in the past will ask, “Is this reversible?” or “What are my options for revision?”

So, to answer the first question is bariatric surgery reversible, the short answer is ‘yes’ and ‘no’.

First of all, it depends on the operation. If you’ve had a lap-band placed, that’s technically reversible because we can simply remove the lap-band and we do that frequently.

The gastric bypass is actually reversible. We rearrange the anatomy for a gastric bypass and that can be un-rearranged.  However, it’s fairly complex surgery and associated with much higher risks. So, that’s not generally something that we typically recommend but it can be done.

A gastric sleeve, however, is not reversible because a portion of the stomach has been removed.

When thinking about revisional weight loss surgery, again it depends on what type of surgery you’ve had in the past.

If you’ve had a lap-band placed, and have either regained weight or are having problems with the band, we can remove the band and will usually consider a sleeve gastrectomy or gastric bypass after that. This is probably the most common revisional surgery that we do here at MIIS Weight Loss Institute – removing an adjustable gastric band and converting it to another operation.

Revisional surgery, if you’ve had a prior sleeve, is often considered for patients who have regained weight or have developed significant reflux or sometimes more rare complications of a sleeve gastrectomy. Usually that involves one of two operations. Either the sleeve can be converted to a gastric bypass, which is helpful for people who have reflux and/or weight regain. Sometimes, if there is a problem such as a narrowing at some point, that can also be corrected with a gastric bypass. However, if the only issue is weight regain, the gastric bypass can be a good option.  Also, there are newer procedures that are showing a lot of promise such as a modified duodenal switch, a SADI-S or SIPS procedure.  You may hear different names, but all of those are good options for patients who have weight regain after a sleeve without any other significant problems.

If you had a gastric bypass in the past, this is where it can get a bit complex. It really depends on what’s going on and what’s causing the problem. Sometimes there can be an issue with the pouch, sometimes there can be an issue with the connection of the stomach pouch to the small intestine, sometimes it can be an issue with the small intestine itself, or sometimes there are simply no problems with it and no options for revision for the gastric bypass. So, patients who have had a previous gastric bypass really need an in-depth evaluation to understand what is going on to see what’s causing the problem and what’s causing the weight regain. Only at that point can we decide if there are revisional options that we can provide.

In summary, every patient is different so we take each case on an individual basis and after a detailed evaluation and discussion, we can decide whether or not a revisional surgery is warranted.

If you have any further questions, please reach out to us!