Revisional Bariatric Surgery

Bariatric and metabolic surgery is still the most effective treatment for obesity; 5x better than weight loss medications. However, some patients may experience weight recurrence, inadequate weight loss, acid reflux, or other complications after their initial bariatric procedure that may require surgical revision. At Alabama Weight Loss Surgery, our surgeons have extensive experience performing revisional bariatric surgery. We evaluate each patient individually and select the procedure that best addresses their current anatomy, weight-loss goals, medical conditions, and complications from a previous operation. Revisional bariatric surgery can be more complex than an initial operation because of scar tissue, altered anatomy, and other changes from the original procedure. Our goal is to provide a safe, individualized surgical plan designed to address the reason for revision while maximizing the potential for long-term success.

Sleeve Gastrectomy Revision

Patients who have previously undergone sleeve gastrectomy may experience inadequate weight loss, significant weight recurrence, or troublesome acid reflux. Depending on the patient's circumstances, we offer conversion of a sleeve gastrectomy to either Roux-en-Y gastric bypass (RYGB), one-anastomosis gastric bypass (OAGB), or single-anastomosis duodenal-ileal bypass (SADI). The choice between gastric bypass and SADI depends on each patient's individual circumstances, including the presence or absence of reflux, weight-loss history, current anatomy, and overall health.

Sleeve to Gastric Bypass

Conversion of a sleeve gastrectomy to Roux-en-Y or one-anastomosis gastric bypass may be particularly beneficial for patients who have developed significant acid reflux after sleeve gastrectomy. Gastric bypass can address reflux while also providing additional weight-loss and metabolic benefits.

Sleeve to SADI

For patients whose primary concern is inadequate weight loss or significant weight recurrence after sleeve gastrectomy, SADI may be an effective revisional option. SADI combines the restrictive component of the sleeve with intestinal bypass to provide greater metabolic and weight-loss effects.

Gastric Bypass Revision

Although Roux-en-Y gastric bypass is a highly effective and durable bariatric procedure, some patients may experience inadequate weight loss or significant weight recurrence over time. Other patients may develop complications involving the gastric pouch or connection between the stomach and intestine.

Conversion to Distal Gastric Bypass

For patients with significant weight recurrence or inadequate weight loss following gastric bypass, conversion to a distal gastric bypass may provide additional weight-loss and metabolic effects. This procedure increases the amount of intestine that is bypassed while maintaining the existing gastric bypass anatomy.

Revision for Marginal Ulcer Disease

Marginal ulcers can develop at the connection between the gastric pouch and small intestine following gastric bypass. When marginal ulcer disease does not respond adequately to medical treatment or when there is an underlying anatomical problem, surgical revision may be necessary. Our surgeons can evaluate patients with recurrent or complicated marginal ulcers and determine whether revision of the gastric pouch or gastrojejunal anastomosis is appropriate.

Revision for Anastomotic Stricture

An anastomotic stricture is a narrowing of the connection between the stomach pouch and small intestine following gastric bypass. While many strictures can be treated endoscopically, some patients with persistent or recurrent strictures may require surgical revision. We offer evaluation and surgical treatment for patients with difficult or recurrent anastomotic strictures.

Adjustable Gastric Band Removal and Revision

Adjustable gastric bands, including LAP-BAND® and Realize Band® procedures, were once among the most performed bariatric operations. Some patients may eventually experience inadequate weight loss, weight recurrence, difficulty swallowing, reflux, or other band-related complications.

We offer adjustable gastric band removal, either as a standalone procedure or in combination with conversion to another bariatric operation. Depending on the patient's anatomy, medical history, and weight-loss goals, the band may be removed without another bariatric procedure or converted to another operation such as sleeve gastrectomy, one-anastomosis gastric bypass, Roux-en-Y gastric bypass, or another appropriate bariatric procedure.

An Individualized Approach to Revisional Surgery

There is no single revisional procedure that is appropriate for every patient. The best operation depends on the original procedure, the patient's current anatomy, the amount of weight lost or regained, the presence of reflux or other complications, and the patient's overall health and goals. You should only trust dedicated bariatric experts, like Alabama Weight Loss Surgeons, for this challenging re-operative surgery. Our surgeons will carefully review your previous operative history, weight-loss journey, current symptoms, and available imaging or endoscopy before recommending a surgical plan. If you have experienced weight recurrence, inadequate weight loss, acid reflux, an ulcer, an anastomotic stricture, or another problem after previous bariatric surgery, we can evaluate your situation and discuss whether revisional bariatric surgery may be appropriate for you. Your insurance should pay for revisional surgery to correct a problem such as reflux or obstruction, but almost no insurance will pay for a revision for weight regain. Fortunately, we have the best self-pay prices in the nation for revisions!