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What You Need to Know About Surgical Revision to Gastric Bypass

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For most patients who undergo bariatric surgery, the procedure is a successful one that helps them lose weight and achieve a healthy lifestyle. However, a small percentage of weight loss surgery patients may choose to seek a surgical revision for one of any number of reasons. Some patients may not be satisfied with their weight loss after a primary bariatric procedure, while others may experience a complication or failure of their original procedure, such as the need for frequent “fills” of a lap-band, band slippage or a stretched pouch.


The good news is that patients who have experienced a failed bariatric procedure have options for getting back on track and losing the weight for good. Some of the most common surgical revisions include band-to-sleeve and sleeve-to-bypass procedures, but a revision of Roux-en-Y Gastric Bypass (RYGB) is another option.


As an experienced bariatric revision surgeon, Dr. Todd McCarty recommends this procedure to gastric sleeve patients who have been unsuccessful with the sleeve, but who do not have an enlarged sleeve. Occasionally, in these cases, a patient’s lack of success with the sleeve may be due to a sugar addiction, which leads to dumping syndrome. For these patients, a revision from sleeve to gastric bypass is more successful than revising the sleeve itself.


Lap-band patients who have been dissatisfied with their band procedure may also opt for a revision to gastric bypass, although we recommend that most band patients convert to the trademarked and patented Mini Sleeve.


Gastric bypass is commonly seen as a more complex bariatric procedure, as it involves the re-routing of the small intestine to attach to a small pouch that is created in the upper stomach. The pouch is created by stapling off a section of the upper stomach to reduce the amount of food that can be consumed. The pouch is then attached to part of the small intestine, called the Roux limb. Any food the patient eats bypasses the remainder of the stomach and upper part of the small intestine, reducing the amount of fat and calories that are absorbed from the food.


A primary RYGB procedure takes about 30 minutes, but a revision of RYGB generally takes about 60 minutes. The primary risk of complication in this procedure is leakage from the staple line. Revision patients have a slightly higher risk for complications — about five percent, compared to about 0.003 percent for primary sleeve and bypass patients.


If you have had a prior bariatric procedure and are unsatisfied with the results, or have experienced complications from the procedure, contact Dallas’ leader in bariatric innovation, Dr. Todd McCarty. Dr. McCarty has more than 20 years of experience helping patients achieve long-lasting weight loss and regain their health. He can help you choose the bariatric revision procedure that is right for you.