Revision weight loss surgery
Revision surgery repairs or modifies a previous weight loss operation, or converts one operation into another. It is no longer only about fixing complications — it is also about giving a patient a second chance at the result they were after the first time.
The two operations most often revised are the Lap-Band and the Sleeve Gastrectomy. Whatever you had done, the first step is the same: find out what has actually changed. That usually means an upper GI swallowing study and an endoscopy, performed by a bariatric surgeon who does revision work.
Which revision applies to you
Find the operation you had. Each page covers the symptoms, how we diagnose the cause, and what your options are.
Lap-Band revision
If you're struggling to swallow solid food, having food stick, living on liquids and soft foods, or fighting heartburn that no longer responds to medication, you may have one of these:
- Lap-Band intolerance — unable to eat solid food
- Esophageal dilatation — stretching of the swallowing pipe
- Obstruction — band too tight, too high, or slipped
- Band slippage — an enlarged pouch causing intermittent obstruction
- Band erosion — the band rubbing into the stomach
Sleeve revision
The most common reasons for revising a Sleeve Gastrectomy:
- Heartburn or reflux not responding to medication
- Incarcerated or herniated sleeve — trapped in the chest
- Stricture or torsion — a narrowed or twisted sleeve causing obstruction
- Biliary reflux, gastritis or esophagitis — bile irritating the stomach and esophagus
- A large or incomplete sleeve
- Weight regain, or not enough weight loss
Gastric bypass revision
The most common reasons for revising a Gastric Bypass:
- Weight regain, or no weight loss
- Gastro-gastric fistula — the pouch has reconnected to the remaining stomach
- A large or horizontal gastric pouch
- Marginal ulcer at the gastro-jejunal anastomosis
- Stricture at the gastro-jejunal anastomosis
- Obstruction
- Heartburn or reflux not responding to medication
- Incarcerated or herniated stomach — pouch trapped in the chest
Heartburn, reflux and hiatal hernia
Heartburn and reflux are among the most common complaints that lead to revision surgery — whatever operation you originally had.
The symptoms have several possible causes. They may come from an obstruction, or from bile reflux — bile irritating the esophagus and stomach while presenting as ordinary acid reflux. Telling them apart matters, because the treatment is different.
An upper endoscopy and an upper GI study are usually what establish the cause.
Heartburn, reflux and hiatal herniaSigns worth getting looked at
These symptoms usually get worse rather than better. If any of them describe you, see a bariatric surgeon who does revision work — sooner is genuinely easier than later.
Trouble swallowing that makes you cough, choke or vomit when you eat, lie down or sleep
Food getting stuck, repeatedly
A narrowing diet — living on liquids, sauces and soft food while avoiding anything solid, dry, dense or doughy
Heartburn or reflux that has stopped responding to medication
Weight regain, or weight loss that never came
Pain or vomiting after eating that has become part of normal life
Find out what actually changed
Book an appointment to talk through your symptoms. An upper GI study and an endoscopy will usually show what has happened — and only then can we tell you what can be done about it.