Weight loss surgery successfully treats obesity, however, it can and does fail at times for a variety of reasons. Patients may need reoperation surgery to solve weight regain or anatomic complications; it can be categorized as conversion, corrective, or reversal.
With the growing number of bariatric surgeries performed, an increasing portion of patients requires a second surgery due to the undesirable results of their first-time procedure. Patients who do not reach their goal weight should not feel a failure. Weight loss surgery is a tool and does not work 100% of the time for everyone.
Revisional bariatric surgery is a highly complex and technical operation with a higher chance of complications and a lower chance of success.
Mexico Bariatric Center® works with an exclusive network of best bariatric surgeons in Tijuana who have the expertise and experience revising outdated, unsuccessful, or botched primary bariatric surgeries. Just to name a few, revision of Lap-Band®, Gastric Sleeve, Roux-en-Y Gastric Bypass, VBG, etc.
When Bariatric Revision is Needed
For any procedure that failed due to complications or insufficient weight loss, alteration surgery may be a great option. Associated surgical problems including fistula, staple line leak or slipped gastric band. Associated medical problems including ulcers, scar tissue strictures, or inability to absorb vitamins and minerals.
Reoperation of Primary Weight Loss Procedures Incidences:
- Gastric Sleeve – Around 6% to 19% of patients with sleeve gastrectomy require a revision.
- RNY Gastric Bypass – Around 15% to 35% of patients with gastric bypass require a revision.
- Adjustable Gastric Band (AGB) – Around 10% to 60% of patients with Lap Band require a revision.
- Vertical Banded Gastroplasty (VBG) – Around 30% of patients with VBG require a revision.
- Gastric Balloon – Around 50% of patients with gastric balloon require a revision.
Below we explain each revision option that we provide in full detail.
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1. Gastric Sleeve Revision
If gastric sleeve does not produce sufficient weight loss or difficulties occur, conversional surgery is needed. Vertical Sleeve Gastrectomy failure can be caused by:
- Pouch enlargement
- Patient’s body adjusting to lower caloric intake
Many patients opt to convert gastric sleeve to RNY Bypass, Mini Bypass, Duodenal Switch or re-sleeve. All these options should work to increase the amount of expected weight loss. List of revisional surgeries:
- Gastric Sleeve to Gastric Bypass / Mini Bypass – Sleeve gastrectomy to RNY gastric bypass is one of the most effective weight loss reoperative procedures.
- Gastric Sleeve to Duodenal Switch
- Re-Gastric Sleeve – The sleeve to sleeve is not very effective for most patients, and many patients complain of slow to no weight loss. This procedure is slightly more effective on patients who have a severely dilated (stretched stomach). A patient’s clinical history will often tell if a patient’s current sleeve is ineffective.
Julie – Gastric Sleeve to Mini Gastric Bypass Revision
Gastric Sleeve Revision starts at $5,495 $5,095*
2. Gastric Bypass Revision
If roux-en-y gastric bypass fails to produce desirable weight loss, revising to another surgery type could be ideal. If patients lose too much weight, the RNY gastric bypass reversal could be an option.
Gastric Bypass Failure Causes:
- Pouch enlargement
- Staple-line disruption
- Stoma enlargement
- Patient’s body adjusting to lowered caloric intake
Although gastric bypass is considered to be semi-permanent, patients can convert to a variety of options including a Lap-Band. In Lap-Band, the band is placed around the stomach to help induce weight loss. RNY Revision Options:
- Shrink the stoma by injecting a sclerosant (“sclerotherapy”)
- Reduce the Size of the Pouch
- Add Lap-Band around the stomach (lap band surgery)
- Lengthen the Roux limb (distal bypass)
- Conversion to BDP-DS could be better than distal bypass
Revisal surgeries, specially RNY Revisions, are associated with lower success rates and much higher complication rates than the original procedures.
Karla – Gastric Bypass Revision Surgery
3. Adjustable Gastric Banding (AGB) Revision
Increasing consensus is the dissatisfaction of gastric band as a tool to treat obesity. More and more patients are experiencing insufficient weight loss and undesirable complexities. The most common conversional surgery is Lap-Band to Gastric Sleeve.
The gastric sleeve provides the restriction familiar to Lap-Band patients but also includes suppression of appetite. List of Options for Revision Of Laparoscopic Adjustable Band :
- Re-Adjust Lap-Band Placement
- Lap-Band to Gastric Sleeve
- Lap-Band to Gastric Bypass
- Lap-Band to Duodenal Switch
Statistically, up to 70% of all lap band patients will have some form of complication, and ten years post-op no longer have their lap band. Gastric band operation failure can be caused by:
- Pouch enlargement
- Poor access to adjustments
- A certain percentage of patients simply do not lose weight with Lap-Band.
Leoni – Lap Band to Gastric Sleeve Revision
4. Vertical Banded Gastroplasty (VBG) Revision
Vertical Banded Gastroplasty, or stomach stapling, is an outdated weight-loss procedure that uses stitches and an implant to achieve weight loss. Developed by Dr. Edward E. Mason, the developer of the original Gastric Bypass in 1966, it was originally developed in 1980. Since that time, long-term studies over ten years show disappointing results.
Compared with other surgery options, Vertical Banded Gastroplasty doesn’t produce significant weight loss and can allow patients to regain their weight. Other possible reasons for weight loss failure is the lack of duplicate stitching (a practice that is now standard), which can tear or open. When this happens, patients must convert to another surgery.
Surgeries VBG can be revised to:
- Gastric Sleeve Surgery (Likely)
- Gastric Bypass Surgery (Less Likely)
Patients with weight loss surgery must also factor in their personal genetics. Certain individuals are merely designed to store fat and several years after weight loss surgery, their bodies adapted to the malabsorption component and lowered caloric intake, and patients begin to gain weight slowly again.
Risks of Weight Loss Surgery Revision
Patients considering revision surgery must also be aware that the second surgery has almost a 50% higher rate of complications than the first one. Human tissue does form adhesions as a response to any disturbance such as surgery. Adhesions vary from person to person and have no bearing on the external scars on the skin. The bariatric re-operative surgery takes much more operating room time and skill because of the careful dissection of layers of adhesions.
Risks common with correctional surgeries are leakage, the necessity to revise a laparoscopic surgery to open operation, incisional hernia (from open surgeries), bleeding, etc. With all revision surgeries there is always a risk with anesthesia, this can be minimized by using a surgical team with extensive knowledge in bariatric surgery.
Great strides have been made in the field of trans-oral surgery (surgery via an endoscopy procedure). While this area is still very experimental and in its infancy, this type of surgery may offer a low-risk alternative in the future to repairs of enlarged stomas and other types of reoperations.
Mexico Bariatric Center Revisional Case Studies
Patients who had conversion surgery due to inadequate weight loss experienced a significant decrease in body mass index (BMI), from an average of 55.4 to an average of 35, and an average loss of 68.9 percent of excess body weight. The outcome depends completely on the revision surgery option and the effectiveness it has on the patient.
At Mexico Bariatric Center, less than 4% of sleeve patients need a second surgery to get to their ideal weight. Converting gastric sleeve to mini bypass at MBC Tijuana surgical center has been the most effective update option.
Patient – Bariatric Surgery Revision
Success Rate of Bariatric Surgery Revision in Mexico
At Mexico Bariatric Center, we want patients to be informed of all the options and success rates so that they are able to make an educated decision for themselves. MBC’s Tijuana surgeons have extensive experience in rescuing botched and failed surgeries. Consult our specialized multidisciplinary revision center in Tijuana, Mexico to help you see which correctional surgery fits you best.
Arethza – Bariatric Revision Surgery