Cedars Sinai Marina del Rey Hospital Alert: COVID-19 (CORONAVIRUS) information for patients and visitors LEARN MORE >>

Revisional Weight Loss Surgery: What Is It and Why Would I Need It After Bariatric Surgery?

Jeremy Korman';

By Jeremy Korman

Posted on October 7th, 2018 in Weight Loss

Failure after bariatric surgery is defined as achieving less than 50% of excess weight loss over 18 to 24 months.

Simply put, a revisional weight loss surgery refers to a kind of surgery that can be done after one has already had an operative intervention with the purpose of losing weight but it did not meet their expectations in terms of results.

This should not be looked at as a reason to feel ashamed, nor should it be thought of as a failure of which one party is responsible for exclusively.

The healthy approach would be to reach out to a professional, have your unique situation assessed, and then agree on the appropriate solution.

Revisional surgery may be also necessary for:

    • Patients who have not lost as much weight as intended. They may undergo revision or conversion to a different weight loss procedure.
    • Patients who have lost too much weight. They may undergo a reversal of the original weight loss procedure.

Reasons Your Weight Loss Surgery Failed

In the majority of the cases, maintaining weight loss after surgery is a success, however, there are circumstances in which the post-surgery results are not what the clients envisioned for themselves. Plainly, this means that the patients quickly regain weight, which deems the operation ineffective.

A few reasons why the initial weight loss surgery proved to be inefficient might be:

      • medical complications that happened during the procedure or shortly after it
      • poor assessment and management of comorbidities
      • lifestyle changes (for example: changing eating habits because of pregnancy, job schedule, financial issues)
      • lack of physical activity
      • depression

You should also take into consideration the fast-paced rhythm based on which medical knowledge and technology grow and improve. Surgeons continually learn from their gathered experience and so with the help of new equipment they are able to nowadays do that which was a hypothetical solution only a few years back. If what you had in mind for your weight loss journey could not be made possible in the past, it might be a thing of reality in today’s medical scenery. If you would like a certain procedure done, it is worth doing the research and finding the specialist to talk to about it.

Types of Revisional Weight Loss Surgeries

If revisional weight loss surgery is agreed upon as being the best option for you to pursue, then there are a few options that you might want to consider in order for you to obtain the best results:

      • Band over bypass surgery. A flexible gastric band made of silicone is positioned around the upper part of the stomach. Under normal circumstances, it is performed laparoscopically. It is the procedure that has the highest rate of revision, with the advantageous aspect being that your doctor can regularly re-adjust the band for a long period of time in order to maintain your weight loss.
      • Sleeve gastrectomy. A big part of the stomach is cut out, and the remaining fragment is remodeled to take the form of a tube or a sleeve. Thus, the sensation of hunger in patients decreases, leading to weight loss. Usually, it is performed laparoscopically, and only sometimes the traditional large incisions in the abdomen are needed. Compared to other types of interventions, the possibility for risk is low, and you may only have to spend one or two nights in the hospital post-surgery.
      • StomaphyX revision. It is an entirely endoscopic technique. The endoscope is inserted through the mouth into the stomach pouch, then the link between the stomach pouch and the small intestines are sutured, slowing down the process of emptying the stomach and resulting in the sensation of satiation. There are no cuts involved and, therefore, no established recovery period. The patient will just have to get used to the different needs when it comes to eating.

Risks of Revisional Weight Loss Surgeries

You are free to make a guess as to what revision weight loss surgery would work best for you, but make sure you have a serious conversation with a weight loss expert as well so that you can make an informed decision and have the most desirable outcome. You should always be aware of the risks that one intervention or another may have, most commonly being:

      • heavy blood loss
      • incidental infections
      • longer surgery and recovery time
      • odd leaks
      • open and wider incisions

Due to more and more people suffering from obesity, weight loss surgeries have become a more common procedure than in the relatively near past. With the number of weight loss surgeries on the rise, so is the fraction of patients that require revisional interventions. There is not one single procedure that would fit the needs of everybody wanting to lose weight, which is why it is essential to have your medical history, eating habits and also psychosocial considerations carefully examined by a medical professional for you to benefit most out of the course you choose to take for your health.

Coming to Terms with Your Failed Weight Loss Surgery

The starting point is generally to have a discussion with your doctor in order to figure out exactly the cause of your weight regain. More often than not, the solutions suggest a more determined refocus on the regimen that the person was recommended to follow in the first place, but that, for some reason or another, had been abandoned. Therefore, a more disciplined approach to diet and exercise might just be the answer to the problem.

It is important to understand that it is not the case of everybody that has had weight loss surgery and is not losing weight at the rate they had hoped to have a revisional weight surgery. Then again, on the other hand, in some instances lifestyle changes are not significant enough to be considered the root of the problem. The fact is that even with a successful surgery, the stomach will inevitably stretch out again over time, which means that the patient will be craving more food in order to feel full. Because identifying the causes can be such a slippery slope, it is better to involve a professional in the decision-making.

Have You Regained Weight After Bariatric Surgery? We Can Help You

At Cedars-Sinai Marina del Rey Hospital we understand that bariatric surgery is not "the easy way out", because it requires hard work, sacrifice, and an expert medical team to see you through it. Get to know the pioneers of minimally-invasive weight-loss surgery techniques who would be helping you live a healthier life.

If you’ve had poor weight loss, weight regain, or complications of the original procedure, such as ulcers for Roux-en-Y gastric bypass or slippage of the LAP-BAND, you may qualify for revisional bariatric surgery. For other questions and answers about revisional bariatric procedures and the types of revisions done, call us today.