Bariatric procedures are designed to promote rapid weight loss and relieve obesity-related comorbidities. By tampering with the stomach and anatomy, food intake is restricted while reducing caloric absorption. Most persons looking to undergo EndoSurgical procedures often ask this question: “Is bariatric surgery reversible?” Patients generally seek reversal surgery due to the following:

  • Medical complications
  • Severe side effects
  • Inadequate weight loss
  • Malnutrition/Excessive weight loss

Only a handful of laparoscopic and endoscopic operations are truly reversible. In this article, we will identify the reversibility of bariatric procedures and outcomes that will likely transpire. We will also uncover all bariatric surgeries that can be fully or partially reversed.

Is Bariatric Surgery Reversible?

Yes, but not all; there are very few weight loss procedures that are truly reversible. Unless there are traumatic side effects, severe complications, or undesirable results, there is no reason to reverse a procedure. Also, not very many weight loss surgeons are able to reverse a previous bariatric surgery.

How do we define “reversiblity?”

Reversiblity represents the ability to undo or revert a weight loss system to its original pre-surgery state.

In most cases, bariatric procedures that can be undone involve a foreign device inserted into the body to aid in restricting calorie intake. Some of these foreign bodies are designed to be removed at some point and can be extracted without any permanent changes to the body.

Reversible vs. Permanent Bariatric Procedures

Whether you get an endoscopic or a laparoscopic procedure, weight loss will be achieved by altering the stomach’s capacity (restrictive) and/or adjusting to the digestive tract by rerouting the intestines (malabsorptive). That is why most bariatric procedures, such as gastric sleeve and duodenal switch, are irreversible. If a procedure is not 100% reversible, returning it to its original state may cause complications.

Bariatric ProcedureMethodologyReversibility
1. Gastric BandLaparoscopic60%
2. Gastric BalloonEndoscopic100%
3. BariclipLaparoscopic80%
4. Endoscopic Sleeve GastroplastyEndoscopic70%
5. Gastric Sleeve PlicationLaparoscopic80%
6. RNY Gastric BypassLaparoscopic10%
7. Duodenal Switch (BDP/DS $ SADi-S)Laparoscopic10%

1. Gastric Band (LAP-BAND)

Lap Band Surgery in Mexico - Gastric Banding Schematic

Description: Adjustable Gastric Banding is a restrictive method that puts an inflatable silicone ring planted laparoscopically over the stomach. Gastric banding aims to limit food intake, and it can be adjusted or removed at any time. Roughly 20% of excess weight loss is achieved after one year. A significant number of patients require lap band reversal due to experiencing food intolerance, slippage, erosion, port infection, and inadequate weight loss. The patient needs a conversion of their bands to sleeve gastrectomy or RNY bypass to keep the weight off.

Reversal Option: The band is retrieved by cutting through built-up scar tissue to expose the silicone device. The surgeon cuts the band from the stomach and carefully resects it from the abdominal cavity.

2. Intragastric Balloon

Gastric Balloon Weight Loss System - Mexico Bariatric Center

Description: The gastric balloon system is a temporary solution to jump-start weight loss. A balloon-like device inflated with gas or saline is inserted into the stomach endoscopically. Patients tend to feel a decreased stomach capacity/volume and unease when eating. The balloon comes in many different brands with an estimated weight loss of 15 to 25 lbs over a 6 to 12-month period. Individuals who experience serious discomfort, blockage, nausea, and vomiting are signs of balloon intolerance and typically require reversal.

Reversal Option: First, the surgeon deflates the balloon endoscopically. At that point, it is extracted from the esophagus and out of the mouth. Gastric balloons are rarely preserved in the body longer because the risk of deterioration and gastric damage increases over time. The balloon can be extracted sooner if requested.

3. Bariclip

Bariclip-Schematic reversable surgery

Description: The laparoscopic clip gastroplasty is a silicon-covered titanium clip placed over the stomach’s greater curvature. The procedure imitates the effect of a gastric sleeve by restricting food capacity in the stomach. Patients typically report an average of 20% excess weight loss in a rather short time. According to the founders of Bariclip, the procedure is alleged to be 100% reversible.

Reversal Option: Since no part of the anatomy is resected, the procedure can be reversed. Bariclip can be removed laparoscopically before if desired, or after reaching your weight loss goal.

4. Endoscopic Sleeve Gastroplasty

Endoscopic Sleeve Gastroplasty - Reversible Bariatric Surgery Procedures

Description: Like gastric plication, ESG folds the stomach by cross-stitching sutures that are pulled like a drawstring to shrink the gastric capacity. Around 25% of total body weight loss is reduced after 12 months.

Reversal Option: To undo this procedure immediately, the surgeon will release the cross-stitch sutures. If removed in a short time frame, the stomach can return to normal. In some cases, the stomach stabilizes into a sleeve form, causing the procedure to be permanent. It is reversible to a degree, but because of the nature of the procedure, a reversal may result in complications.

Patients not reaching the ideal weight with Endo Sleeve can get a revision to a traditional VSG.

5. Gastric Sleeve Plication

Gastric Plication Surgery Schematic - How it Works - Sleeve Plication in Mexico

Description: Gastric plication begins when the stomach is folded, or plicated, inward along the greater curvature. Staples are utilized to maintain and hold the fold. By reducing the stomach size to a “banana shape” similar to the gastric sleeve, weight loss will be accelerated. Usually, 15-20% of weight loss is reduced from the total starting body weight.

Reversal Option: By removing the sutures and staples, the total plication reversal can return the stomach line to its original size. Long-term studies have controversial outcomes with this procedure as results vary from patient to patient.

Gastric Plication can be revised to a vertical sleeve gastrectomy.

6. RNY Gastric Bypass

RNY Gastric Bypass vs Gastric Sleeve

Surgery Description: Gastric bypass, also known as Roux-en-Y (RNY), helps accelerate and maximize weight loss by combining malabsorption with restriction. Malabsorption is created by bypassing the small intestines, resulting in significantly fewer nutrients being absorbed in the body, allowing food to pass without storing excess fat. The restriction is formed by creating the new “egg-sized” stomach pouch known as the stoma. Detaching the stomach from the stoma allows for fewer ghrelin hormones to be present, making the patient feel full much quicker.

Reversal Option: The reversal for RNY returns the intestines and stomach back to their original placement. Having reversion in the same area can lead to more complexities and risks of leaks, increased bleeding, infection, and scar tissue build-up. With such a demanding weight-loss operation, reversal surgery should be the last option if there are no other alternatives.

Reversing a permanent surgery, such as RNY gastric bypass, is complex and requires a super surgeon.

7. Duodenal Switch

duodenal switch schematic Mexico bariatric centerDescription: The Duodenal Switch with biliopancreatic diversion and its variation single-anastomosis DS procedure have two components:

  1. Sleeve gastrectomy to restrict the amount of food intake
  2. Separation of the biliopancreatic juices and the food to reduce the amount of nutrients absorbed

Reversal Option: Obviously, the removed portion of the stomach cannot be reintroduced to the pouch. The second part of the operation, however, can be re-anastomosed. This reversal of switch operation is done by creating a new anastomosis between the biliopancreatic limb and the alimentary limb.

Is Bariatric Reversion Safe?

Almost all laparoscopic surgeries, such as gastric sleeve, are non-reversible. Reversible surgeries, like Lap-Band, are only in theory as they are considered impractical and often dangerous. Re-operation causes damage to the affected area and increases bleeding risks. Scar tissue can lead to longer operating times and more complex surgeries. Besides the associated dangers of reversing a bariatric surgery, you increase your likelihood of regaining back the weight or more.

Pros and Cons of Reversible Bariatric Surgery Infographic

Endoscopic procedures are primarily reversible; however, they are not as effective in losing extra weight and curing comorbidities. An intragastric balloon, for example, is a relatively safe and 100% reversible procedure but only suitable for patients with lower BMIs who are disciplined.

Before undergoing any EndoBariatric surgery, make sure you consider all the pros and cons. Consult with highly qualified Mexico Bariatric Center’s surgical teams for the best option for you!