• Insufficient Weight Loss: Some patients may not achieve the expected amount of weight loss within a specified period after surgery. If they lose less than 15% of their total body weight, they may be candidates for revisional surgery.
• Complications: Complications can arise from the initial bariatric procedure, such as gastric band slippage, erosion, or leakage, gastric fistula, hiatal hernia, ulcers, or strictures.
• Side Effects: Patients may develop side effects after the initial surgery, such as acid reflux, difficulty swallowing, or symptoms like GERD.

Revisional bariatric surgery aims to address these concerns and improve the patient’s overall outcomes following weight-loss surgery.

The approach to revisional bariatric surgery varies depending on the issues that arose following the initial procedure and whether surgeons intend to repair, convert, or reverse the original surgery.

• Sleeve Gastrectomy: Initially, this procedure involves surgically removing a significant portion of the stomach, reducing its volume by 80%. Over time, the stomach may stretch or enlarge, leading to weight regain. To address this, surgeons typically convert sleeve gastrectomy to gastric bypass or a duodenal switch procedure. Converting to gastric bypass can also effectively manage GERD symptoms that may have developed post-surgery.
• Gastric Bypass Surgery: During this procedure, a small pouch of the upper stomach is sectioned off to hold food, and part of the small intestine is rerouted to this pouch. Over time, the pouch may stretch or enlarge. This can be corrected surgically, endoscopically, or through anti-obesity medications. Additionally, gastric bypass can be converted to a Single Anastomosis Duodenal-Ileal Bypass with Sleeve Gastrectomy (SADI) or reversed by reattaching the stomach, performing a gastric sleeve, and reattaching the previous small bowel while attaching a loop of the small bowel to the end of the gastric sleeve.
• Gastric Band Surgery: Also known as Lap-band surgery, a silicone belt is placed around the upper stomach to divide it into two sections, helping patients feel full sooner. If the band slips out of place, surgeons may reposition it or remove it temporarily before replacing it. Alternatively, gastric band surgery can be converted to sleeve gastrectomy, gastric bypass surgery, or the SADI procedure.

Revisional bariatric surgery aims to address complications or insufficient outcomes from the initial procedure, improving the patient’s overall health and well-being.

Revisional bariatric surgery is utilized to address complications, insufficient outcomes, or undesired effects stemming from a previous bariatric surgical intervention. Initial bariatric procedures are often recommended for individuals with obesity as an effective means to achieve and sustain weight loss. However, various circumstances may necessitate follow-up surgery to rectify these issues.