Gastric Bypass Revision

A gastric bypass revision is a procedure that fixes a problem or improves the results of gastric bypass surgery. Your healthcare provider can perform a revision to change or correct the original surgery.

You may choose revised gastric bypass surgery if you have complications or develop issues, like ulcers or acid reflux. You may also decide to have the procedure if you’ve had serious weight regain.

If you haven’t reached your target weight or you’ve had issues after bariatric surgery, talk to your provider about your options. They may recommend a gastric bypass revision.

How do I qualify for gastric bypass revision surgery?

You may qualify for gastric bypass revision if the original surgery causes problems or doesn’t work the way it should.

Common reasons for considering a revision include:

• Complications from the first surgery, including ulcers, reflux, strictures (narrowing) or pain
• Return of health issues like type 2 diabetes or high blood pressure
• Weight regain or not losing enough weight after the first surgery

Before going forward with a revision, your healthcare provider will do a full checkup. This usually includes:

• A discussion about your daily routine to see whether nonsurgical options might help
• Nutritional tests to find and correct any protein or vitamin deficiencies
• Imaging to look at your stomach and intestines and understand what went wrong with the first surgery
• Any nonsurgical management, like medications or endoscopic intervention

How does a gastric bypass revision work?

A gastric bypass revision works by changing or repairing parts of your first gastric bypass surgery to help correct the problem. There are two main gastric bypass revision options: surgical revision and endoscopic revision.

Surgical revision

With surgical revision, your provider performs surgery again. Depending on the reason for the surgery, they may:

• Make your stomach pouch smaller again
• Fix leaks
• Repair ulcers
• Change how food moves through your intestines

Sometimes, your provider converts the bypass to a different type of bariatric surgery, like a duodenal switch or sleeve gastrectomy. Gastric bypass revision surgeries are more complex than the first surgery. They also take longer, have more risks and have a higher chance of complications.

Endoscopic revision

With endoscopic revision, your provider doesn’t have to perform surgery again. Instead, they do an endoscopy. You’ll still be under anesthesia. But the procedure is less invasive. And you should be able to go home the same day.

First, your provider inserts a flexible tube with a camera and tools through your mouth and into your stomach. Then, they tighten or stitch the connection between your stomach pouch and intestines. This makes it smaller, which helps you feel full faster.

What is the gastric bypass revision success rate?

Healthcare providers consider a loss of 50% or more of the excess weight as a common benchmark for success. Using this standard, one study measured results one and three years after revision. According to the study, 6 in 10 people successfully lost at least half of the excess weight. After three years, about 7 in 10 people reported the same success.

What are the potential benefits of this procedure?

Gastric bypass revision has many potential benefits. These include:

• Weight loss: Weight regain is less common after a revision. This is especially true in the first one to three years after the procedure.
• Improved health: Obesity-related health conditions like diabetes and sleep apnea often improve. For some people, their symptoms go away completely.
• Quality of life: You may find that you have more energy, enabling you to move better. You may also have a boost in your self-confidence.

Is a gastric bypass revision dangerous?

Gastric bypass revision comes with more risk than the original bariatric surgery. But depending on your situation, it might be worth it. One of the reasons it has a higher risk is that it’s more complex than the first surgery. Parts of your body (stomach, intestines) have already changed once.

Risks and complications may include:

• Bleeding
• Infection
• Anastomotic leak
• New nutritional deficiencies
• Need for another operation
• Bowel obstruction
• Dumping syndrome

How long will it take for me to recover?

Gastric bypass revision recovery time depends on the type of procedure (surgical or endoscopic) and your overall health.

If you have surgical revision, you can expect to stay in the hospital anywhere from one to seven nights. You can return to doing light activities within one to two weeks. After four to six weeks, you may be able to return to work.

If you have endoscopic revision, you’ll usually go home the same day as the procedure. You can return to doing light activities within one to three days. After one to two weeks, you can probably return to work.

For both types, you’ll need to slowly reintroduce food to your body. First, you’ll only have clear liquids. Then, you can move up to full liquids and pureed foods. You’ll graduate to soft solid foods two to six weeks after the revision. Eventually, you’ll be eating what you’re used to — usually after six to eight weeks.

When should I call my healthcare provider?

After gastric bypass revision, it’s important to watch out for warning signs of an infection or other issues. These may include:

• Fever or chills
• Worsening belly pain, or pain that doesn’t get better
• Nausea or vomiting
• Skin discoloration, swelling or pus at the surgical site (for surgical revisions)
• Unusual drainage or foul-smelling fluid at the surgical site (for surgical revisions)

How many gastric bypass revisions can you have?

There isn’t a set number of times you can have a gastric bypass revision. But each time you have surgery, it becomes more complex and risky.

Some people may only need one revision to fix a problem or help with weight regain. Others might need more than one if new issues develop or if earlier revisions don’t fully solve the problem.

Every surgery adds scar tissue and increases the chance of complications. So, providers try to avoid multiple surgical revisions whenever possible. That’s why less invasive options, like endoscopic revisions, are becoming more popular. Your provider can often repeat them safely if needed, and they don’t make future surgeries harder.