For various reasons, people sometimes don’t achieve the results they’dhoped for after a bariatric (weight loss) procedure. When this hap pens, revision weight loss surgery may be an option.
What is bariatric revision surgery?
Bariatric revision surgery involves having another operation to help you reach your long-term weight loss goals. It’s also known as revision weight loss surgery. Revision surgery is most commonly used after gastric banding but sometimes after other types of weight loss surgery.
Why would I need revision surgery?
For people living with obesity, bariatric surgery is a highly effective way to achieve significant and lasting weight loss. However, things don’t go according to plan in every single case. Reasons for revision bariatric surgery include the following.
Insufficient weight loss or weight regain after surgery
Some people don’t lose as much weight as they expected after bariatric surgery. Others have excellent results initially but regain weight later. This can happen for several reasons.
Lack of consistency with making healthy changes after surgery or returning to unhealthy habits that led to weight gain in the first place can sabotage your weight loss results.
The mechanical or anatomical changes your surgeon made can sometimes lose effectiveness over time. For example, a lap band may slip, or the small stomach pouch can stretch after sleeve gastrectomy, allowing you to eat more.
The type of surgery you had initially did not adequately meet your metabolic needs.
Over years you may require medication which can lead to weight gain.
Inadequate management of health conditions
Many people have weight loss surgery to help control weight-related health conditions such as type 2 diabetes. If you don’t lose enough weight to improve your health, revision bariatric surgery may be considered.
Complications after weight loss surgery
Occasionally, people experience complications after a primary weight loss procedure that may necessitate a revision bariatric procedure. Examples of these complications include:
- malnutrition or vitamin deficiencies
- anaemia
- severe reflux symptoms
- ulcers.
It’s important to note that revision weight loss surgery is not necessarily the first line of action for the above issues. Your surgeon will investigate why they’re happening and order some tests to find out more. They will probably recommend other strategies, such as medication and support to make healthy lifestyle changes, before considering a revision procedure.
What procedures can be revised?
Here are some examples of revision bariatric surgery.
• Gastric balloon or endoscopic procedures can be revised to a laparoscopic sleeve gastrectomy or gastric bypass.
• A gastric band can be removed or converted to a gastric sleeve or bypass.
• Gastric sleeve surgery can be converted to a gastric bypass or a loop duodenal switch with sleeve gastrectomy.
• A single anastomosis gastric bypass can be converted to a Roux-en-Y procedure.
How do I get a referral to a weight loss surgery expert?
If your GP (General Practitioner) thinks you could benefit from weight loss surgery, seeking advice from a bariatric surgery expert is the next step.
Our world-class surgeons offer advanced weight management procedures at various locations Australia wide. Ask your GP to refer you to one of our experienced specialists or doctors who perform bariatric surgery.
Your doctor can address the referral to a specific specialist or doctor, or simply to ‘Dear Doctor’.
What happens during weight loss revision surgery?
The process involved in a revision bariatric procedure will differ for each person depending on the type of primary surgery and why you’re having a revision. Revisional surgery is more complicated than primary bariatric surgery. Your surgeon will order some imaging tests and do an endoscopy to learn more about what is going on.
However, here are some common examples of what your surgeon might do.
Bariatric revision surgery after a gastric band (lap band)
While gastric bands are designed to stay in place permanently, they can loosen and become less effective. If this happens, the first step involves removing the band and the stitches that held it in place. Then your surgeon can examine the area and give you advice about whether another procedure is suitable. Revision options include a laparoscopic sleeve gastrectomy or gastric bypass procedure.
Bariatric revision surgery after sleeve gastrectomy
The choice of revision procedure after gastric sleeve surgery will depend on why it’s needed (to deal with weight regain or reflux symptoms, for example). Your surgeon will first do an endoscopy, which involves gently inserting a thin, flexible tube down your food pipe to examine the area and the sleeve. Depending on what they find, revision surgery options include:
A gastric bypass procedure
These procedures involve redirecting the digestive tract to bypass a section of the stomach and the upper part of the small intestine. This reduces the area where food can be digested so you absorb fewer nutrients and calories. Types of gastric bypass include laparoscopic mini bypass (also known as single anastomosis and omega loop bypass), single anastomosis duodeno-ileal bypass with sleeve (or SADI), and Roux-en-Y gastric bypass. Each one has different benefits and risks. Your surgeon can explain these in detail and provide advice about which option could work best for you.
Bariatric revision surgery after gastric bypass
A gastric bypass revision is more complex than other bariatric revision procedures.
If the stomach pouch has stretched, your surgeon can tighten it and put a ring in place to help stop it stretching again. If the surgical join (anastomosis) between the stomach and upper part of the small intestine has stretched it can also be tightened. If stretching is not the issue, your surgeon can redirect your digestive tract to further reduce the area where nutrients and calories are absorbed.
Your surgeon will explain their findings and provide advice tailored to your needs.
What are the complications of revision weight loss surgery?
Revision bariatric surgery can be more complex and difficult to perform. This means it carries a higher risk of complications such as:
- excessive blood loss
- infection
- leakage from staple lines
- need to convert to an open (versus a laparoscopic) surgery
- longer time in surgery.
Your highly trained surgical team will do everything possible to minimise risks and ensure surgery goes as smoothly as possible. Nonetheless, it is important to understand the pros and cons before deciding to go ahead. Your surgeon can give you tailored advice and answer your questions to help you make an informed choice about whether to have weight loss revision surgery.
What does recovery after revision bariatric surgery involve?
This will depend on which procedure you have. Many people only need a few nights in hospital. You may need to stay longer after a more complex or open surgery or if you experience any complications.
You can take over-the-counter pain medications such as paracetamol once you get home, or your doctor might prescribe pain medications for a short period. It’s important to take any medications as prescribed.
Your wound or wounds will be covered, and dressings are normally removed about 10 days after surgery. You’ll need to take it easy in the days following surgery to avoid straining your wounds. It’s a good idea to have someone around who can help you with everyday tasks at home.
Your surgeon or dietitian will explain the diet you need to follow. You’ll be on liquid foods to start, gradually progressing to soft moist foods, then solid foods. You will need to continue taking nutritional supplements.
You can usually start walking a few days after surgery. Most people can get back to their usual activities within two to four weeks and driving after a week or so. Your weight loss surgeon will talk to you about returning to work and when to start exercising. You’ll have a follow-up appointment with your surgeon a few weeks after your operation and regular reviews after that.
Revision bariatric surgery FAQs
How much does bariatric revision surgery cost?
This can vary significantly depending on the type of surgery you have and your private health insurance. Your surgeon can explain costs and funding options.
Will insurance cover revision weight loss surgery?
Most private health funds cover bariatric surgery under their top insurance (‘gold’) hospital tier. It’s best to check with your fund to make sure.
Does Medicare pay for bariatric revision surgery?
If the procedure is considered to be medically necessary, Medicare may cover part of the revision surgery cost. You need to meet several requirements. Talk to your surgeon about whether this may be an option for you.
We’re a Centre of Excellence
Norwest Private Hospital was evaluated based on rigorous and proven standards set by SRC. Accreditation requirements encompass physicians’ surgical expertise and experience, the standardisation of clinical pathways, consultative services, equipment and instruments, and patient education.
This accomplishment demonstrates Norwest Private Hospital’s commitment to delivering the highest standard of care and excellence to our patients.
Find out more about bariatric & weight loss surgery at Norwest Private Hospital
*Whilst effort is made to ensure that the information contained on this website is accurate and informative and it has been reviewed by a qualified medical practitioner, the information is general in nature, and it should not be used as a substitute for obtaining your own professional or medical advice. Any timeframes or quantitative data including but not limited to estimated timeframes for recovery following a procedure, time required for the procedure, timeframes for weight loss and/or estimated total weight loss are general in nature and your experience, outcomes and results may vary.
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