Will I Need a Revisional (Second) Bariatric Surgery or Conversion?

Surgical robot with operating room light behind

Dr. Jacobs’ Key Points

  • Revisions are reserved for a small number of patients who are regaining weight or having problems with their procedures.
  • Gastric bands are commonly removed and converted to gastric sleeves.
  • A gastric sleeve can be converted and revised, often for GERD or chronic acid reflux.
  • Weight loss medications may help some patients restart their weight loss or maintain their results.
  • The Gastric Sleeve Center is a leader in revisional surgeries.

Whether you’ve lost weight through diet and exercise, weight loss medications, or bariatric surgery, the specter of weight regain is petrifying. This is because we’ve likely experienced and seen this before. We lose significant weight, but life gets in the way, and we begin to regain it. The result often returns us to where we were before, sometimes gaining even more. Unfortunately, weight gain is a real possibility after any weight loss intervention, and it’s why we specialize in revisional bariatric procedures. For many bariatric patients, maintaining their new lower weight is possible for many years after their procedure. However, ten or even 20 years down the road, the effects of lax diet and exercise habits can allow for weight regain that is unacceptable, and patients are looking for a reset.

Before discussing revisional surgery and whether you need it, let’s talk about why most people regain weight and/or consider revision/conversion procedures.

  1. They have relaxed their lifestyle and are now eating and drinking more. This may include high-fat and high-sugar foods that introduce hundreds more calories into their diet each day. An occasional misstep is not a problem, but consistent overeating over months or even years can stretch the gastric sleeve pouch or force the stoma open in a gastric bypass. There’s always a way to cheat the surgery.
  2. While the gastric sleeve is a simple and elegant solution, it comes with a concern of new or worsened reflux. When accounting for a hiatal hernia repair, we have reduced this incidence to about 5 to 10%, but it still exists. If we cannot manage this reflux medically or endoscopically, the gastric sleeve must be revised. You can learn more about two ways to revise a gastric sleeve here.

Will You Need a Revision?

If you are a new patient looking forward to your initial surgery, you can take heart in knowing that we have more surgeries and techniques available today than ever. This allows us to tailor the surgery to your circumstance, thus making surgery safer and more effective. We will discuss the potential risks of each surgical procedure, including the chances of a revisional procedure sometime in the future. This in-depth information lets you decide whether a particular surgery is appropriate.

If you have had a gastric sleeve and you are experiencing significant reflux, you must come to our office whether you’ve had surgery with us or not. We can discuss the potential options for managing this reflux up to and including revisional surgery.

Revision or Weight Loss Medication?

Some patients who have liberalized their lifestyle habits and are consequently gaining weight may benefit from a weight loss medication like Wegovy or the newly approved Zepbound. These are both GLP-1 receptor agonists that can help patients lose weight. You can learn more about our take on weight loss medications and the recently approved Zepbound by Lilly.

The Bottom Line

While weight regain and revisional surgery are possible, patients who closely follow their postoperative diet and exercise program can often maintain their weight loss long into the future and even for the rest of their lives. Particularly diligent patients can lose as much weight as they wish, and we’ve even had a patient who competes nationally and internationally as a bodybuilder. The sky is the limit.

In rare cases, the surgery may not be appropriate for your circumstances. However, this can be mitigated by employing a highly experienced physician with a firm grasp of modern techniques and technology who has an objective view of the weight loss options available to their patients.

We look forward to seeing you at our office for a consultation. Helping you understand your weight loss options is paramount to ensuring your happiness and success with your procedure. Click here to schedule a consultation with Dr. Jacobs.