Gastric Bypass Revisions

For over 40 years the gastric bypass has been considered the gold standard in bariatric surgery. Until recently, the bypass was far and away the best option for those looking to lose a significant amount of weight and improve or resolve most of their obesity related diseases. However, even gastric bypass patients can begin to gain weight over the years.

As we do with any patient who has regained weight, we first analyze their diet and exercise habits to see if the weight regain is possibly caused by a liberalization of the post-operative lifestyle. If this is the case, patients will work with our nutritionist to get back on track.

It is also important to note that gastric bypass patients tend to regain approximately 5 to 10 percent of their excess body weight loss about 2 to 3 years after their procedure. This is perfectly normal and well within the margins of success.

However, if a revision of a gastric bypass is warranted, it is usually because the stomach pouch has stretched and is not offering sufficient restriction. In this case, patients have several options.

First, a gastric band can be placed around the top of the gastric pouch to increase restriction. We typically avoid this due to the relatively higher long-term complication rate of the band compared to stapled procedures.

Second, if the dilation of the stomach pouch is manageable, there are several and endoscopic options for increasing restriction. These options do not require surgical access to the abdomen, rather a specialized device is passed through the esophagus into the stomach, where It increases restriction through one of various mechanical techniques.

Another manageable complication that may be seen several months or years after the gastric bypass is the dilation of the stoma – the opening between the stomach and small intestine. During the gastric bypass, the natural stoma my is cut away and is surgically reconstituted. Over time, or the stoma may enlarge, allowing food to enter the small intestine largely undigested. This can also be corrected endoscopically.

While, in theory, the gastric bypass can be reversed, the risks are simply too great and success rates are low. 

Risks of a Gastric Bypass Revision

Procedures employed to improve the restriction of a gastric bypass are typically very successful, offering the patient renewed long-term weight loss. It is important that patients employ an experienced bariatric surgery center such as ours to mitigate some of the most common risks of gastric bypass revision. Risks and consideration will be discussed fully at consultation.

Insurance Coverage for a Gastric Bypass Revision

Insurance coverage for a gastric bypass revision is usually determined on a case-by-case basis. We will work with you to submit the appropriate documentation to the insurance company.

Next Steps

Patients who have had a previous bariatric surgical procedure do not need to attend a seminar before their consultation. Please contact us to schedule a time to meet with one of our three bariatric surgeons.