Gastric Bypass Revision

On average, gastric bypass patients can lose around 70% of excess body weight initially following surgery. However, what about the chance of weight regain?

At the 2 year follow-up, these patients were likely to gain at least 5% of their excess body weight back. When looking at long-term results, about 41% of bariatric patients experience weight regain by the 10 year follow-up after gastric bypass surgery.

Although gastric bypass surgery is generally considered a successful weight loss solution, many elements can lead to failure. This would include some behavioral and lifestyle factors along with surgery complications and side effects that appear years later. Bariatric surgery is only a tool to jump start weight loss. In the long-term, it's the patients responsibility of adhering to lifestyle changes that maintain weight loss. 

However, this information is not meant to scare you out of getting weight loss surgery. It's to ensure that you are informed on what can happen when lifestyle change is not maintained after bariatric surgery. If it comes down to it, there are bariatric revision surgeries that can help you get back on track. Continue reading for more in-depth information about gastric bypass revision surgeries.

 

What Is a Gastric Bypass Revision? 

A gastric bypass reconstruction is any surgery done to correct a failed gastric bypass surgery. This would include reducing stomach size, performing another weight loss surgery, or adding an adjustable band. The surgery can correct excessive weight regain or solve a complication like heartburn after gastric bypass. 

Some individuals may be skeptical about corrective surgery due to the costs of their first gastric bypass surgery and how long it took. However, the gastric bypass revision success rates are proof enough to continue the weight loss journey. 

 

Can You Have Gastric Bypass Surgery Twice?

This decision is made on an individual basis. It is possible to have a second gastric bypass surgery or gastric bypass revision in order to repair or redo the procedure.

If you have undergone a full or mini-gastric bypass surgery, it is possible to regain weight and there are corrective options available. 

However, depending on why gastric bypass failed, the revision surgeon will decide if you’re eligible for a second one. For example, if your gastric bypass pouch stretches due to poor eating habits and an unhealthy lifestyle, you will be encouraged to follow up with a bariatric dietitian rather than undergo another surgery.

On the other hand, if the anatomy of your stomach and small intestine has changed, causing some complications, gastric bypass revision may be recommended. For example, a gastric fistula may form, creating an unwanted opening causing the stomach and intestinal contents to leak. 

In the case that gastric bypass fails due to weight regain, the first solution should be exercising, following a strict diet, and giving your body the nutrients it needs by taking the right bariatric supplements. This will help you to achieve your weight loss goals without going under the knife again. 

Bariatric Fusion can help you with preparation for any bariatric procedure. Our affordable, all-inclusive Multivitamin Bundles can provide you with all of the vitamins and minerals required to prevent deficiencies and provide a successful weight loss journey. Our on staff dietitian and professional experience may provide guidance on how to restart weight loss after gastric bypass.

Bariatric Fusion provides a variety of bariatric specific supplements in order to prevent and even correct deficiencies. Your healthcare provider may recommended products like Bariatric Iron and Calcium Supplements in order to correct deficiencies caused by gastric bypass malabsorption syndrome associated with surgery.

 

Gastric Bypass Revision Options

Gastric revision surgeries come in many forms. Some of them are major surgeries and others are considered less invasive approaches. 

Before undergoing any corrective surgery, your provider should perform a full upper gastrointestinal tract radiography along with other screening tests to see whether you’re a candidate for gastric bypass revision. If your results show that you’re eligible, your provider will discuss the following options with you.

1. Sclerotherapy

A possible cause of weight regain after bariatric surgery is related to stoma dilation. The gastric stoma is the opening between the stomach and the small intestine. When the gastric stoma expands, more food may be consumed and  possibly result in weight regain.  

Sclerotherapy is a minimally invasive outpatient procedure that involves injecting the enlarged stoma with an irritant that induces scarring. The stoma will constrict, thus reducing the size of the opening and restricting the amount of food you can consume. 

2. Lengthening the Roux Limb  Lengthening the Roux Limb

This revision comes with increased risks, however, it is highly effective for weight loss. The procedure consists of lengthening the Roux limb (the middle part of the small intestine). The surgeon connected this limb to the upper part of your stomach in order to bypass most of the stomach and duodenum. 

With a 15% rate of leakage after this procedure, there will be much to take into consideration before making this decision. Research has indicated that extending the length of the Roux limb can help achieve drastic weight loss results in patients with BMI exceeding 50.  

3. Transoral Outlet Reduction (TORe)  

This is also known as Endoscopic Gastric Revision. It is considered a minimally invasive procedure. A scope is inserted and used to further reduce the size of the stomach pouch.

Before the procedure is performed, your bariatric provider will perform a number of tests to ensure the stomach stretching is due to weight gain. 

After experiencing gastric bypass stomach stretching, the goal of this revision is to reduce the size of your stomach so that you can reach satiety earlier in your meals and increase weight loss efforts. 

The operation is quick and you are usually discharged from the hospital the day after surgery. It also requires less recovery time than other bariatric surgeries.  

4. Conversion to Duodenal Switch  Conversion to Duodenal Switch

Sometimes, patients with a BMI over 50 who don’t respond well to gastric bypass are recommended a duodenal switch conversion.

The goal of this procedure is to bypass a larger amount of the small intestine in order to leave a smaller surface area for calories to be absorbed. The lower end of the small intestine would be reconnected to the stomach pouch. 

While the excess weight loss from duodenal switch surgery is much higher than that of gastric bypass, there are increased complications associated. People who undergo this surgery develop significant nutritional deficiencies from malabsorption. Duodenal switch surgery requires a different supplement regimen that includes higher amounts of specific vitamins and minerals. There are higher risks of internal bleeding, leaks, and bowl obstruction. 

5. Lap-Band Addition   Lap-Band Addition

There is the option of adding an adjustable gastric band to the stomach pouch in order to overcome a failed gastric bypass surgery. The operation involves implanting a silicone band around the upper portion of the stretched stomach pouch. This will further restrict the intake of food and thus induce a sense of satiety earlier during a meal.

6. Candy Cane Removal  

In some cases, patients can develop complications years later after gastric bypass. You will undergo a number of tests in order to rule out the cause of complication.

Sometimes, the complications are caused by Candy Cane Syndrome. This issue

Candy Cane Removal

occurs when the portion of the small intestine that was connected at the stomach pouch becomes dysfunctional. Food particles can lodge causing nausea and abdominal pain. 

A procedure is required as intervention for this complication in order to remove the non-functioning portion of the small intestine. 

 

Final Thoughts

Now that you know the gastric bypass revision options, it’s important to remember that these surgeries also have their complications and risks. Your bariatric surgeon will utilize these options as a last resort when all other solutions fail.

Also, note that the high success rates after revision procedures results as patients become more diligent about following their doctor’s guidelines to lead a healthier lifestyle with decreased bariatric regain

Bariatric surgery and revision surgeries are only a tool for weight loss. There can be reoccurring cases of weight gain if the proper lifestyle changes are not implemented.

 

**This blog is for information and education purposes only. This information is not intended to substitute professional medical advice, diagnosis, or treatment. Please consult with your physician or another qualified health provider with any questions in regards to a medical condition.