Revisional Bariatric Surgery

Revisional bariatric surgery is a second weight loss operation performed when the first one doesn’t produce enough weight loss, or when weight is regained years after the initial procedure. It may convert a previous surgery to a different type — for example, turning an adjustable gastric band into a sleeve gastrectomy or gastric bypass — to restore or improve weight loss results.

Revisional bariatric surgery refers to a secondary or conversion procedure performed on patients with inadequate weight loss (defined as less than 50% excess weight loss at 18 months) or significant weight regain (more than 25% of lost weight) after primary bariatric surgery. Common conversions include laparoscopic adjustable gastric band to sleeve gastrectomy or Roux-en-Y gastric bypass, sleeve to gastric bypass, and Roux-en-Y gastric bypass to distal bypass or biliopancreatic diversion. Revisional procedures carry higher complication rates (5–15%) compared to primary surgery.

Weight regain after bariatric surgery is more common than many patients expect, affecting 20–30% of patients within 10 years. Dr Joseph Wang at Accord Medical evaluates patients with post-surgical weight regain to determine whether revisional surgery or medical management is the most appropriate path forward.