Gastric Bypass Revision in Tijuana, Mexico

RNY Gastric Bypass Surgery, or Roux-en-Y Gastric Bypass (RYGB), is the gold standard of bariatric surgery for managing obesity. Regaining weight following bariatric surgery is not uncommon. Patients with poor weight loss often feel angry or depressed. There are corrective procedure options available if desired.

According to a study that appeared in Annals of Surgery in 2006, 35% of super obese patients and 20% of morbidly obese patients who had the gastric bypass gained back at least 50% of their weight after 10 years.[1]

Mexico Bariatric Center® provides a wide array of endoscopic and laparoscopic revisional weight loss surgery in Tijuana and Guadalajara, Mexico. Mexico Bariatric Center’s top bariatric surgeons have extensive experience in revising and reversing failed Roux-en-Y bypass surgeries.

Bariatric Surgery Revision - Mexico Bariatric Center

Surgery Duration
2 – 3 Hours

Hotel Stay
1 Night Pre-Op

Hospital Stay
2 – 3 Nights

Back to Work
2 – 8 Weeks

Benefits of Revising a Gastric Bypass Surgery

Although gastric bypass is effective, a number of patients either fail to lose weight or develop undesired outcomes. If you previously had gastric bypass and need a second surgery, Mexico Bariatric Center provides two options. The main changes that we do in gastric bypass correction surgery include;

Kimberly H - RNY Gastric Bypass Revision Surgery in Tijuana Mexico

“I highly recommend MBC, my whole experience, as well as my husband’s, was top notch.”

Julie

Gastric Bypass Revision Surgery

What Does the Gastric Bypass Revision Package Include?

The price of Gastric Bypass Revision in the U.S. and Canada without insurance can easily set you back $18,000 to $20,000. Fortunately, we offer U.S. quality weight loss surgery in Mexico at a fraction of the cost. We eliminate all of the planning and preparation by taking care of everything from the moment you arrive in San Diego to the moment you depart. Ground transportation, hotel stay, and everything in between are covered in our all-inclusive package.

  • Private Ground Transportation
  • Accredited Hospital with ICU
  • Board Certified Surgeons
  • Hospital Stay & Fees (2-3 nights)

  • Nutrition Program
  • 1-Month Supply of Vitamins*
  • Online Support Group

  • U.S. Surgeon Liaison

  • No Hidden Fees

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When Revision Surgery is Necessary

Just because you have not been experiencing the expected results from your operation doesn’t necessarily mean you should get the salvage procedure. Your doctor will first want to rule out other reasons for not losing weight or gaining some weight back and determine if you are a good candidate for the Roux-en-Y gastric bypass re-operation.

Your Diet 

The first and most apparent thing to rule out is your diet. Start keeping a food journal of what you have been eating, and be as honest as you can. Write down every bite of food, including drinks, that you consume on any given day to help you and your doctor find the right path. If your diet looks to be to blame, changing that first is going to avoid an expensive and possibly unnecessary procedure. Try out the 10-day pouch reset diet.

Exercise

After your gastric bypass procedure, diet and exercise are equally important. Cutting back on your food intake and eating healthier isn’t enough to lose excess weight and keep it off. Part of your post-surgery instruction is to get a moderate amount of activity as soon as your body has healed. Learn about exercise after bariatric surgery.

Types of Gastric Bypass Revision

Roux Limb

Reduce Pouch Size and Bypass More Intestines

  1. Reduce pouch size: The first step to a gastric bypass revision is to reduce the small stomach pouch. Over time the pouch increases in size and becomes bigger. In those cases, we try to shrink your stomach pouch smaller which ultimately reduces stomach capacity for food intake.
  2. Bypass more of the intestines: The second step is going into that bypassed portion. Normally we see six feet of intestines bypassed, or rerouted. If your previous bypass surgery was 10+ years ago, surgeons would only bypass 3 feet. This is referred to as a “short bypass”. We distalize that intestine to increase the length of the rerouted portion. So instead of having 3 or 4 feet of your intestines bypassed, we lengthen that portion and you will have about 6 to 8 feet. Distalize means to increase the length of rerouted intestines.
Endoscopic Gastric Bypass Revision - Transoral Gastric Outlet Reduction (TORe)

Transoral Outlet Reduction (TORe)

Endoscopic treatment can also shrink an enlarged GastroJejunal Anastomosis (GJA). In this non-surgical procedure, the stoma gets retightened with a narrow tube going down the esophagus. If your doctor finds that your pouch size is too large, they may do so with either a StomaphyX, TORe, or ROSE approach.

StomaphyX is an endoscopic suturing system used to reduce the size of the dilated stomach pouch and stomach outlet.
Transoral Outlet Reduction (TORe) endoscopy is a novel non-invasive revisional option to delay gastric pouch emptying. Full-thickness suturing to plicate the gastrojejunal anastomosis can be accompanied by argon plasma mucosal coagulation (APMC).

Gastric Band

LAP-BAND

Incorporating the Lap-Band® into the Roux-en-Y gastric bypass is a revision alternative. Adjustable Gastric Banding (“Salvage Banding”) is helpful in patients whose gastric pouch dilatation is the reason for gastric bypass failure.

In lap band surgery, a small adjustable silicone band is placed at the upper end of the stomach to reduce stomach size. This procedure is performed with laparoscopy by small incisions on the abdomen that heals quickly. If performed in a properly selected person, it results in excessive weight loss over months.

RNY gastric bypass stoma revision options - Mexico Bariatric Center

Shrinking the Stoma

The first option for gastric bypass revision surgery is to shrink the stoma by an injection called a sclerosant, in a procedure known as sclerotherapy. Sclerosant is made up of sodium correlate and is injected into the gastric pouch, which is the space between your stomach and small intestine. If the procedure’s problem was dilating your stoma, this injection could help.

Usually, it requires 2-3 injections over some time. In the August 2007 issue of Gastrointestinal Endoscopy, a study was performed on potential weight gain after bariatric procedures[2]. The average patient who got these injections lost at least ten more pounds in 6 months. Minor complications are possible, including abdominal pain, bleeding, and small ulcers.

This method surgically corrects the diameter of the stoma, which is the restrictive part of the original gastric bypass. Minor cuts are made through the skin in your belly to restore the pouch size to 1 cm laparoscopically. The operation is complex, not consistently successful, and requires a hospital stay.

Duodenal Switch Surgery (DS) icon

Duodenal Switch Surgery

Duodenal Switch is an alternative treatment for patients with gastric bypass failure. Gastric bypass to DS conversion is technically complex and associated with higher risks. The operation needs a bariatric program with certified surgeons with awareness and experience. The bariatric surgeon must have rigorous criteria in the patient screening process to minimize adverse outcomes.

In this procedure, a small banana-shaped stomach is created, and two parallel limbs of the small intestine are formed. The size of the gastric pouch formed in the previous surgery is of prime importance for the surgeon to be able to create the sleeve.

Food passes through a separate channel, and the liver and pancreas juices are drained through another channel. This procedure does not allow the mixing of food with digestive juices, so, little absorption of ingested food, and the patient loses weight quickly. Extra dietetic care is necessary to prevent long-term nutritional deficiencies.

Starts at $7,690 $7,090*

Bariatric Surgery Revision Before and After Photos

Heather M Before
Heather M After
Heather
Andrea C Before Revision
Andrea C After Revision
Andrea
Amy H Before Revision
Amy H After Revision
Amy
Jessica H Before Revision Surgery
Jessica H After Revision Surgery
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Shiann C Before Revision
Shiann C After Revision
Shiann
Jennifer before Revision Gastric Sleeve to Gastric Bypass_Mexico Bariatric Center
Jennifer After Revision Gastric Sleeve to Gastric Bypass_Mexico Bariatric Center
Jennifer S
Kimberlin before revision surgery
Kimberlin after revision surgery
Kimberlin
Joy before revision surgery
Joy after revisions surgery
Joy
Mark before revision surgery
Mark after revision surgery
Mark
Arlene before revision surgery
Arlene after revision surgery
Arlene
Bailey before revision surgery
Bailey after revisions surgery
Bailey
Tiffany before revision surgery
Tiffany After revision Surgery
Tiffany
Deena Before
Deena After
Deena
Kimberly H VSG to RNY before
Kimberly H VSG to RNY after
Kimberly
Brenda Sleeve to Bypass before
Brenda Sleeve to Bypass after
Brenda
Adriana sleeve to mini before
Adriana After
Adriana
Autumn before revision surgery
Autumn After revision surgery
Autumn
Arethza - Bariatric Surgery Revision Before Picture
Arethza - Bariatric Surgery Revision After Picture
Arethza
Julie - Gastric Sleeve to Mini Gastric Bypass Revision Before Picture
Julie - Gastric Sleeve to Mini Gastric Bypass Revision After Picture
Julie
Karla - Gastric Bypass Revision Before Picture
Karla - Gastric Bypass Revision After Picture
Karla
Leoni - Lap Band to Gastric Sleeve Revision Before Picture
Leoni - Lap Band to Gastric Sleeve Revision After Picture
Leoni
Patient of Bariatric Surgery Revision Before Picture
Patient of Bariatric Surgery Revision After Picture
Anonymous

RNY Reversal With or Without Gastric Sleeve

Reversing the RNY Bypass has become more popular with the advancement of laparoscopic bariatric surgery. The risk of the operation depends on the level of albumin in the blood and not the surgical approach.

How is Bypass reversal performed?

  1. Dismantling the duodenum from the gastric pouch
  2. Dismantling the jejunum from the lower part of the intestinal tract.
  3. The duodenum (roux limb) reconnects with the jejunum (biliopancreatic limb) like it was previous to the RNY procedure.
  4. The gastric pouch is to re-anastomosis to the gastric remnant to form the original stomach.

In RNY patients with malnutrition, it is necessary to prepare them with an intravenous ambulatory nutrition diet.

Why do patients get RNY Reversal?

  • Mal-Nutrition
  • Marginal ulcer
  • Hypoglycemia
  • Food intolerance
  • Short bowel syndrome following small bowel resection due to internal hernia
  • Persistent pain
  • Uncontrollable weight loss

Additionally, the sleeve gastrectomy can then be performed after the reversal of the gastric bypass.

Source: LAPAROSCOPIC REVERSAL OF GASTRIC BYPASS

Potential Tests Your Doctor May Require

After figuring out where you are with diet and exercise, your doctor will want to perform a few tests. These tests look for other potential causes of your lack of results, to finally figure out if the revision surgery is right for you.

Endoscopy: The endoscopy numbs you with medication, and then places a tube into your mouth and down your esophagus. It can look into your stomach to see the size of your stoma and pouch.

Upper GI: The upper gastrointestinal tract radiography (Upper GI) is a test that looks at your digestive tract in motion. You will first drink a colored dye and in the meantime, have x-rays done to see how you are digesting it.

Eating Test: Finally, there is the eating test. This test measures how much food you can eat before you start feeling full, and mainly shows if the gastric bypass was effective or not.

Gastric Bypass Case Studies

Revisional surgery is technically challenging, requires a longer hospital time, and is often linked with significant risks and diminished efficacy. You may be a candidate for RNY intervention if you have experienced and of the following problem post-operative.

1. Unsuccessful Weight Loss – The most common cause for lack of weight loss is not adhering to nutritional instructions. Ignoring dietary guidelines and consuming high caloric foods can impact the surgery’s success.

2. Weight Regain after Initial Weight Loss – Some patients initially lose weight for several months, but then regain the weight. Causes include changes in diet, dilatation of stomach pouch due to increased food consumption, or even genetics.

3. Botched Surgery – Complications after gastric bypass can happen. Post-operative problems include;

  • Surgical/Anatomical issues: gut anastomosis is narrowed, or stomach pouch is dilated
  • Medical issues: symptoms like diarrhea, ulcers, solid intolerance, dumping syndrome, anemia, severe constipation, severe gastroesophageal reflux disease, nausea, and vomiting

Case Study #1

Patient History

  • 56 years old patient with 54 BMI
  • Had RNY gastric bypass performed 32 years ago in the United States via open surgery
  • History of two more open surgeries for gallbladder removal and liver segmentectomy
  • Gastric bypass surgery was effective for four years until the patient began regaining weight more than she had prior to surgery

Conditions: Hypertension, Diabetes Mellitus, and Hypothyroidism under control.

Study Findings

We begin the surgery laparoscopic with simultaneous endoscopy. We found anastomoses in the gastric fundus 3cm under the Esophagogastric union with all integrity stomach and a Y Roux for bile drain.

The patient had a biliopancreatic length of 50cm and an alimentary length of 190cm. The length of the limbs was correct, but the patient never had the restriction component because the stomach is conserved. We dissect all scares and do a small gastric pouch reset to the standard limit (of 3oz approx).

Case Study #2

Patient History

  • The patient had gastric bypass in the United States
  • During surgery had to do open surgery
  • The patient developed a hernia along the incision
  • She had a hernia removed several times
  • She started gaining weight
  • Gastric bypass surgery was effective for but then the patient began regaining weight

Study Findings

The skilled bariatric surgeon, Dr. Jesus Ceja, did an endoscopy where he determined that the pouch appeared normal. They had to perform open surgery due to the prior procedure.

Dr. Ceja found the second anastomosis (Y Roux) was enlarged as much as 10 cm and had acted like a stomach. Doctors reduced the Y anastomosis to give the patient less absorption so she can lose weight. She is feeling great a day after surgery.

3 Comments

Tonia Nelson April 9, 2017, at 8:08 pm

Looking for someone to help with maybe a revision of my Gastric-By-Pass, that I had performed on me back in 2005.
I have also suffered from bi-lateral lymphedema in both legs… I have had the problem in my legs since the 1990’s. Please help me, someone.

Mexico Bariatric Center April 11, 2017, at 6:38 pm

Give us a call at 855-631-2413 if you’d like to see if we can help.

Evelyn Tolentino August 31, 2017, at 10:37 pm

Where can I get help because I had gastric bypass surgery in 2013 and have had a lot of complications diarrhea, constipation, vomiting, anemia, gain weight again and it has been too difficult to lose weight?