Revision Bariatric Surgery

All revision surgeries are performed as a laparoscopic, one-step procedure, regardless of how the previous surgery was performed.

Many individuals undergo weight loss surgery to improve health, manage diabetes, or achieve a healthier lifestyle. However, some may not reach their desired goals due to various reasons. If you are experiencing issues such as pain, vomiting, lack of weight loss, or inadequate restriction from your initial surgery, Revision Bariatric Surgery might be the solution for you.

Is Revision Surgery Right for You?

  • Does your band cause discomfort or fail to promote weight loss?
  • Have you been suffering from increased heartburn or reflux (gastroesophageal reflux disease (GERD)?
  • Has your bypass or sleeve not delivered the expected results?

If you answered yes to any of these questions or have other concerns, revision surgery could be the right choice. At Bryan Brewer MD, our experienced surgeon specializes in evaluating and performing a wide range of revision options, including removal of gastric band, conversion to sleeve gastrectomy or gastric bypass, conversion to duodenal switch or SADI-S, or decreasing the calorie absorption of a gastric bypass. We personalize each treatment plan to meet your unique needs and help you achieve your weight loss goals.

Our Approach to Revision Surgery

Our surgeons aim to perform revision surgeries laparoscopically as a one-step procedure whenever possible, even if your original surgery was done as an open procedure. This approach minimizes recovery time and complications while maximizing effectiveness. In cases where a staged approach is needed, we take the time to fully discuss the process and expectations with you, ensuring you feel confident in your treatment plan.

Types of Revision Surgeries Offered

We routinely perform the following revisions:

  • Conversion of Band to Sleeve, Bypass, SADI-S, or Duodenal Switch: For those experiencing discomfort or inadequate weight loss with a gastric band.
  • Conversion of Sleeve to Bypass, SADI-S, or Duodenal Switch: For patients experiencing increased heartburn or reflux (GERD) or needing enhanced weight loss and metabolic control.
  • Bypass Revision: To address weight regain or complications from the initial procedure.

If you are unsure about the type of surgery you had or don’t see your procedure listed, our team is here to help you understand your options and guide you through the decision-making process.

Revision of Gastric Band

At Bryan Brewer, MD, we specialize in the revision of prior gastric band placements with conversion to an effective bariatric procedure. Research shows that over 50% of patients with a gastric band require some type of revision within five years of their initial surgery. The restrictive nature of the band can lead to symptoms such as acid reflux (GERD), difficulty swallowing or tolerating certain foods (like bread and meat), pain, or frequent vomiting. Fortunately, these symptoms can be effectively resolved with the right surgical approach.

Why Consider a Revision Surgery?

Gastric bands and gastric sleeves primarily work by restricting food intake. However, for many patients, this is not enough to achieve or maintain significant weight loss. Studies indicate that converting a gastric band to a gastric bypass provides the best long-term results. At Bryan Brewer, MD, we prioritize personalized care, discussing all surgical options with you based on current medical recommendations and your comfort level. We believe in creating a surgical plan that suits your needs to ensure the best possible outcome.

Revision Options We Offer

1. Laparoscopic Band to Sleeve Gastrectomy

This procedure involves removing the gastric band along with any surrounding scar tissue. Once the band and port are removed, we proceed with the sleeve gastrectomy. If necessary, a hiatal hernia repair can be done during the same operation.

  • Expected Weight Loss: Approximately 40-45% of excess body weight.
  • Recovery Time: 1 to 3 weeks.
  • Complication Rates: Comparable to a standard sleeve gastrectomy.

2. Laparoscopic Band to Gastric Bypass

Research shows that converting a gastric band to a gastric bypass is the gold standard for band revision surgery. This is typically done as a single-stage procedure, where the band, port, and scar tissue are removed before performing the gastric bypass.

  • Expected Weight Loss: Approximately 60% of excess body weight (e.g., 60 lbs lost for every 100 lbs overweight).
  • Recovery Time: 1 to 3 weeks.
  • Complication Rates: Similar to those for a primary gastric bypass.

3. Laparoscopic Band to Duodenal Switch

For patients with a BMI over 50, we often recommend revising the gastric band to a duodenal switch. This procedure is usually performed as a single-stage surgery, where the band, port, and scar tissue are removed before performing the duodenal switch.

  • Expected Weight Loss: Approximately 80% of excess body weight (e.g., 80 lbs lost for every 100 lbs overweight).
  • Recovery Time: 1 to 3 weeks.
  • Complication Rates: Comparable to laparoscopic duodenal switch.

Revision of Gastric Sleeve

At Bryan Brewer, MD, we understand that while sleeve gastrectomy is a popular and effective weight loss procedure, not all patients achieve the desired results. Whether due to inadequate restriction, severe acid reflux (GERD), or the need for additional weight loss, a revision surgery may be the best option. Our team specializes in two advanced revision procedures:

Many patients who undergo sleeve gastrectomy experience complications such as:

  • Severe Acid Reflux (GERD): Studies indicate a higher incidence of GERD in sleeve patients, even if they did not have symptoms before surgery. For patients with severe reflux that does not respond to medication, converting the sleeve to a gastric bypass can effectively alleviate symptoms by diverting acid and bile away from the stomach.
  • Lack of Restriction: Patients who received a gastric sleeve that was too large will lack the full feeling needed to maintain small portion sizes.
  • Need for Additional Weight Loss: Patients who wish to lose more weight may benefit from converting to a gastric bypass, SADI-S, or Duodenal Switch, which generally offer greater long-term weight loss compared to a sleeve gastrectomy.

1. Revision of Sleeve Gastrectomy to Laparoscopic Roux-en-Y Gastric Bypass

Why Choose Conversation to Gastric Bypass as a Revision Option?

  • Gastroesophageal Reflux Disease (GERD): Conversion of gastric sleeve to gastric bypass is the “gold standard” treatment to stop gastric acid from causing painful heartburn symptoms and damage to the esophagus from acid reflux.
  • Expected Weight Loss: Patients typically lose 50% of their excess body weight (e.g., lbs for every 100 lbs overweight).
  • Recovery Time: 1 to 3 weeks, similar to other bariatric procedures.
  • Surgical Risks: Similar to primary gastric bypass surgery.

This procedure is performed laparoscopically, ensuring a minimally invasive approach with quicker recovery and lower complication rates.

2. Revision of Sleeve Gastrectomy to Laparoscopic SADI-S or Duodenal Switch

For patients with weight regain or a BMI greater than 50, a conversion to SADI-S or a duodenal switch may be the most effective option. Originally performed as a staged procedure in the 1950s, the duodenal switch is now done as a one-stage laparoscopic operation. A SADI-S is a modification of the duodenal switch which provides longer intestinal length for digestion and absorption calories and nutrients. These surgeries are particularly effective for patients who:

  • Have not achieved or maintained sufficient weight loss with a sleeve gastrectomy.
  • Need the most robust weight loss solution with low risk of weight regain.
  • Require a more powerful metabolic effect to resolve obesity-related conditions such as type 2 diabetes.

Revision of Gastric Bypass

Gastric bypass surgery has been performed since the 1970s, evolving significantly over the years. Originally done as an open surgery, it is now almost exclusively performed laparoscopically. Dr. Brewer is experienced in revising both open and laparoscopic gastric bypasses. Regardless of how the initial procedure was done, we perform all revisions laparoscopically. The revision involves two key components: the stomach pouch and the small bowel rearrangement, which enhances the malabsorptive effect of the surgery. Before the revision, an EGD is conducted to evaluate the size of the stomach pouch. Our goal is to reduce the pouch size to enhance the feeling of fullness after a small portion size. Additionally, we modify the small bowel rearrangement to decrease the amount of intestine available to absorb calories, similar to the duodenal switch technique.

  • Expected Weight Loss: Approximately 65% of excess body weight (e.g., 65lbs lost for every 100 lbs overweight). If the stomach pouch is already small and cannot be further reduced, weight loss is typically 50-55 lbs per 100 lbs of excess body weight.
  • Recovery Time: 1 to 3 weeks.
  • Complication Rates: Comparable to laparoscopic gastric bypass.

Revision of Vertical Banded Gastroplasty (VBG)

Vertical banded gastroplasty, also known as “stomach stapling,” was a popular weight loss procedure in the 1990s but is no longer performed due to poor long-term outcomes. Many patients experience inadequate weight loss or regain most, if not all, of their lost weight, similar to the results seen with banding procedures. Research indicates that the most successful outcomes are achieved when revising a VBG to a laparoscopic gastric bypass. The recovery time and complication risks are consistent with our other surgical revision procedures. Patients who undergo this revision typically experience a 60% excess body weight loss, equating to about lbs for every 100 lbs of excess weight.

If you are considering Revision Bariatric Surgery as a weight loss solution or want to schedule a consultation with one of our experienced weight loss surgeons, please fill out the form below or contact us at (214) 838-7171.

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Locations

Dallas

Brewer Bariatrics & Medical Weight Loss

1151 N Buckner Blvd, Suite 308
Dallas, TX 75218

214-324-6127
(fax) 214-324-6627

Rockwall

Brewer Bariatrics & Medical Weight Loss at Texas Health Rockwall

3142 Horizon Rd, Suite 202Rockwall, TX 75032

469-698-1622
(fax) 469-698-1236

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