Dr. GallagerWelcome DR. LAURA LYN GALLAGHER | Board-certified general and bariatric surgery specialist

What is Revision Weight Loss Surgery?

A bariatric revision procedure is designed to help you maintain your weight loss after surgery by identifying the issue(s) that prevented you from losing weight (or keeping it off long-term) after your original operation. In some cases, the stomach may have stretched after gastric sleeve surgery, allowing you to continue consuming larger-than-necessary portions.

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In other cases, particularly after gastric bypass, you may have needed to resort to liquid nutritional supplements and shakes (many of which can be high in sugar) to avoid malnutrition. You may have also suffered unpleasant side effects, such as nausea, vomiting, and severe heartburn after eating or drinking certain items.

Regardless of your type of revision surgery, you should end the process with a stomach that is smaller in capacity, but allows you to absorb all the same nutrients you were able to absorb before. This should minimize your risk of long-term side effects.

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Why Should I Choose Dr. Bagshahi for Revision Weight Loss?

Fort Worth-based surgeon Hossein Bagshahi, MD, FASMBS is highly experienced in all aspects of bariatric surgery. He is one of the few weight loss surgeons who hold the distinction of being a Fellow of the American Society of Metabolic and Bariatric Surgery, demonstrating his advanced skill and credentials in the field. Dr. Bagshahi specializes in minimally invasive robotic surgery, duodenal switch procedures, gastric sleeve surgery, laparoscopic gastric bypass surgery, and the LAP-BAND® weight loss system. His unmatched training in an array of bariatric techniques makes him uniquely qualified to care for individuals who have experienced issues with previous weight loss surgery.

Ultimately, recovering from weight loss surgery can be an uphill climb at times; however, the minimally invasive surgical techniques and continuum of care offered by the medical professionals at Bagshahi Bariatric and General Surgery can help ensure a quick and supported recovery. Dr. Bagshahi will also work with most insurance providers to help make gastric bypass revision surgery and other surgical weight loss alternatives an affordable option for patients. Don’t hesitate to contact Bagshahi Bariatric and General Surgery to schedule your consultation and address outstanding weight loss concerns today.

Reasons For Revision Weight Loss Surgery

For some patients, revision surgery may be necessary when satisfactory weight loss results were not achieved. In other cases, a secondary procedure is sometimes recommended to address complications such as reflux, vomiting, obstructive symptoms, LAP-BAND® slip, chronic pouch or esophageal dilation, or gastrogastric fistula. Prior to performing bariatric revision surgery, we will perform an endoscopy and evaluate your pouch, esophagus, and stoma size to rule out a hiatal hernia or device malfunction. We will coordinate this service with the necessary healthcare professionals to provide a continuum of care.

What are My Revision Weight Loss Surgery Options?

The type of bariatric revision surgery you’ll undergo largely depends upon the problems that have encouraged you to seek out surgical repair. Dr. Bagshahi offers numerous bariatric revision surgery options, including:

  • LAP-BAND® revision to sleeve gastrectomy
  • LAP-BAND® revision to gastric bypass
  • Reversal of gastroplasty (stomach stapling) or gastric bypass
  • Revision or correction of complications

 

In many cases, bariatric revision surgery can correct the underlying issue(s) that may have interfered with achieving success from your original weight loss surgery. We also partner with plastic surgeons in the area to provide services for the removal of excess skin, which is often the next step in a patient’s weight loss journey.

What are Common Weight Loss Surgery Complications?

After listening to your concerns in a consultation, Dr. Bagshahi will discuss the specific medical condition(s) you may be experiencing as well as the treatment options available to you. If you are experiencing complications after bariatric surgery, you may require another operation. In order to achieve continued success from a previous weight loss procedure, it is important to follow the dietary and exercise guidelines established for you by your physician.

For patients who have a hiatal hernia caused by a LAP-BAND® procedure, your surgeon will make several small incisions to reposition the LAP-BAND® or remove the LAP-BAND® entirely and perform a sleeve gastrectomy. If you’ve had a gastric bypass, the surgeon may reverse the bypass and add a LAP-BAND® or perform a sleeve gastrectomy.

For gastric bypass patients who experience weight regain due to the enlargement of a gastric pouch or gastrojejunal anastomosis, we offer transoral outlet reduction. This is an endoscopic surgical suturing procedure performed using Apollo Overstitch. Cleared by the FDA, Overstitch offers a reliable, minimally invasive approach to surgical suturing.

Am I a Good Candidate For Weight Loss Revision Surgery?

Although revision procedures boast many success stories, not everyone is an ideal candidate for weight loss revision surgery. Unless you’re still far from your target weight or you’re suffering from chronic health issues related to your weight (such as diabetes, COPD, heart disease, or even severe lower body joint problems), the risks of such a procedure may outweigh the potential benefits.

That said, if you’re having complications from your original surgery or still have a significant amount of weight to lose, bariatric revision surgery may solve many of your issues while allowing you to reach and maintain your goal weight

Gastric Bypass Revision Surgery

What is Gastric Bypass Revision Surgery?

Gastric bypass revision is a type of bariatric surgery performed when patients have not experienced the expected weight loss or have regained weight after their initial procedure. Often, poor weight loss results are due to gastric bypass medical complications, patient metabolic issues, or food consumption.

Some mechanical issues that may result in failure of the initial gastric bypass surgery include:

  • Anastomotic dilation
  • Pouch dilation
  • Gastrogastric fistula

 

Revision surgery is suggested when conservative treatment fails for medical issues such as:

  • Severe dumping syndrome
  • Stricture
  • Marginal ulcer

 

Dr. Bagshahi can help you determine the cause of your gastric bypass failure and recommend a suitable treatment.

What are My Gastric Bypass Revision Surgery Options?

Patients can experience failure from gastric bypass surgery due to multiple factors. Based on careful evaluation and testing, four options are available to patients under the umbrella of gastric bypass revision surgery. Selection of one of these options can decrease the size of the pouch or stoma. Gastric bypass revision surgery choices are:

  • Sclerotherapy
  • LAP-BAND® surgery
  • Roux limb lengthening
  • Duodenal switch conversion

 

The process will begin with an initial evaluation prior to gastric bypass revision surgery. Medical professionals will assess the pouch, stoma size, and esophagus. Patients will also undergo an endoscopy. After surgery, Bagshahi Bariatric and General Surgery coordinates a continuum of care for patients with the necessary healthcare professionals. Individuals are expected to adhere to dietary and exercise guidelines for optimal results after gastric bypass revision.

Intragastric Balloon Revision Surgery

Although we do not perform the gastric balloon procedure at our practice, the intragastric balloon procedure offers a non-invasive weight loss solution. We advise you to visit our office to discuss comparable solutions that may be safer and more effective for your needs. In general, if you have a gastric balloon placed, a balloon is placed in the stomach and filled with air or saline solution. Since the balloon takes up much of the room in the stomach, it can help prevent overeating and allow individuals to lose weight. For optimal weight loss results, a healthy diet and exercise are recommended and many patients work with a dietician to ensure they’re consuming essential vitamins and minerals. However, the balloon is not a long-term solution. It must be removed, so an intragastric balloon revision will be required at some point. Again, we recommend talking to Dr. Hossein Bagshahi about your goals to determine an optimal treatment to help you achieve your goals, as we do not offer the gastric balloon procedure at our practice.

When is the Intragastric Balloon Removed?

We do not place or remove intragastric balloons at Dr. Bagshahi Bariatric & General Surgery. However, generally speaking, the exact timing for gastric balloon revision can vary depending upon the type of balloon utilized. A balloon may be left in place between three months and one year. However, if you begin experiencing unwanted symptoms with the balloon in place, you may require an intragastric balloon revision sooner. After placement of the balloons, it’s important to follow up with your physician for regular checkups to ensure your balloon is not causing any side effects.

How is the Intragastric Balloon Revision Procedure Performed?

Dr. Bagshahi would be happy to speak to you about effective alternatives to the gastric balloon procedure. While we do not perform gastric balloon surgery or recommend the treatment at this time, the general procedure is relatively short. Just like the placement of the balloons, gastric balloon revision only takes about 30 minutes to complete and the entire procedure is very similar to the initial surgery. At practices that offer the procedure, patients are sedated to minimize any discomfort.

In general, the saline or air will be removed from the balloon. The deflated balloon will then be removed from the stomach. Before the revision procedure, you will need to avoid eating solid food for 24 hours and drinking liquids for 12 hours. It’s important to have someone to drive you home after the procedure, as you will be under the effects of the sedation.

What is Life Like After Intragastric Balloon Revision?

Dr. Bagshahi does not offer intragastric balloon placement or revision, but can answer general questions about the potential results of the procedure. After the intragastric balloon revision is complete, the stomach should return to normal. Many patients appreciate this benefit of the gastric balloon. Since the stomach conforms to its original size, it is important to continue following up with our medical team so you maintain and improve your weight loss.

Without the balloons in place, it may be tempting to eat larger portions again, which can sabotage your weight loss efforts. Ongoing, lasting weight loss is still possible after the balloons have been removed if you continue to eat the lesser portions of food you’ve become accustomed to while the balloons were in place.

It’s essential to continue healthy eating habits and a good exercise plan to continue losing weight, or to keep off the weight you have already lost.

Gastric (Sleeve Gastrectomy) Sleeve Revision

Due to the health complications that often accompany obesity and being extremely overweight, gastric sleeve surgery has become an effective weight loss procedure for many patients. A sleeve gastrectomy is a procedure that removes a large section of the stomach.

The remainder of the stomach is then reshaped into a tube or a sleeve. This will normally produce a decreased amount of hunger and increased satiety, which should both lead to weight loss. Some patients, however, do not lose an adequate amount of weight and a revision surgery may be necessary to achieve additional weight loss.

Reasons For Gastric Sleeve Revision

Revision surgery may be warranted when complications, such as fistulas, strictures, and malnutrition, during an initial gastric sleeve procedure occur. Alternatively, if the stomach stretches—specifically, if portions of the stomach have stretched in a disproportionate manner—your previous gastric sleeve surgery may no longer be effective. This usually means an inadequate amount of weight has been lost, and a revision procedure will be necessary to correct the problem and facilitate weight loss.

In other cases, the anti-reflux barrier between the lower part of the esophagus and the stomach may not function properly after a gastric sleeve procedure. For these patients, gastric bypass is usually considered the best option for a revision procedure.

What are My Treatment Options For Gastric Sleeve Revision?

Revision gastric sleeve surgery is usually performed laparoscopically. This involves making tiny incisions, rather than larger incisions and openings. A second gastric sleeve procedure can be performed to remove any excess volume and re-shrink the gastric area. This procedure is performed similarly to your initial procedure. Another treatment option involves revising the sleeve to duodenal switch or gastric bypass surgery. It should be noted that both the duodenal switch and gastric bypass have more extensive dietary restrictions.

What are the Risks of Gastric Sleeve Revision?

There are always risks when operating on an area that has previously been manipulated or scarred, including the potential for leakage from revision surgery. These risks would need to be evaluated before having gastric sleeve revision surgery. The best way to minimize the likelihood of complications is to find a qualified physician with the experience to guide you through the different steps of sleeve gastrectomy revision.

How Much Does Revision Weight Loss Surgery Cost?

Since the need for revision weight loss surgery generally stems from a medical issue or complication, the cost of a secondary procedure can often be partially or fully covered with insurance. We encourage you to contact your insurance provider to learn the terms of your policy. Our team would be happy to assist you during this process and answer any questions you may have about the cost of bariatric revision surgery. In general, each patient’s cost estimate will depend on details unique to their treatment, such as:

  • The type of procedure necessary to correct the issue(s) at hand
  • Whether anesthesia is required during your revision surgery
  • The overall complexity of the procedure

 

For all other out-of-pocket expenses, our practice accepts a multitude of bariatric surgery financing plans from national lenders like CareCredit®, United Healthcare Credit®, and Prosper® Healthcare Lending. These healthcare financing companies can help qualified patients make their procedure more affordable by presenting a number of low- to no-interest arrangements to choose from. If you have questions about the cost of bariatric revision surgery, please call our practice to speak with a member of our office.

Dr. Hossein Bagshahi can develop a personalized treatment plan for each patient at Bagshahi Bariatric and General Surgery to help ensure the best results possible. For more information regarding revision weight loss surgery in Fort Worth, Texas, contact our practice today.

Schedule A Consultation

The best way to determine if this procedure is right for you is to discuss your concerns, goals, and medical needs with a qualified bariatric surgeon. Contact us today to schedule your initial consultation.

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