Revision Bariatric Surgery

Revision
Bariatric Surgery

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We know regaining weight after bariatric surgery or medical therapy is scary! You are not alone!

Weight gain after gastric bypass surgery occurs in about half of all patients within two years. Despite the weight regain, the average patient still keeps off over 60 percent of their excess weight after five years. About 50 percent of patients eventually gain a little weight back after hitting their low point (also called their “nadir”). The more time that passes following surgery, the more likely patients are to gain back some weight. On average, patients who gain the weight back see about eight percent of their old weight return within five years of surgery. So, if a patient is one of the 50 percent who gains weight back, was 100 pounds overweight, and lost 70 pounds from surgery, on average, he or she can expect to gain back about eight pounds.

The good news is…

The good news is that most patients (about 80 percent of morbidly obese and 65 percent of super obese) keep at least 50 percent of their excess weight off after ten years!

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What can you do about weight regain?

Even if you stay on top of the points discussed on our page about regaining weight, there’s still a chance that you could experience weight gain after gastric sleeve or gastric bypass surgery. We offer several safe incisionless solutions that will get you back on track and losing weight.

Gastric sleeve revision (GSRe)

What is gastric sleeve revision (GSRe)?

Gastric sleeve revision is a procedure that shrinks the stomach to the size it was after a primary gastric sleeve gastrectomy. The procedure follows the same protocol as an endoscopic sleeve gastroplasty (ESG). Refer to the ESG page on this site to learn more about its specifics. It does not require incisions, is performed in our state-of-the-art outpatient surgery center in Atlanta, and you can return home the same day, with a short recovery period.

Watch this short video to find out more about how our Atlanta Gastric Sleeve Revision works.

How much does the procedure cost?

For information on the price of the revision surgery, visit our pricing page. The cost not only includes the price of the surgery but reflects the level of skill and expertise our specialist or medical professional who will perform your revision surgery. Given that endoscopic sleeve gastroplasty is a new procedure, it might not be covered by health insurance.

Gastric bypass revision (transoral outlet revision-TORe)

What is gastric bypass revision (transoral outlet revision-TORe)?

Also known as transoral gastric outlet reduction, this procedure can repair the gastric outlet (the connection between the stomach and small bowel) by reducing its size. To accomplish this revision, we insert stitches into the gastric outlet with an endoscope. This procedure will allow you to feel full earlier when eating, lose weight, and hopefully maintain the weight loss throughout the years. It does not require incisions and is performed in our private, luxury outpatient surgery center. You will return home the same day and can return to your usual activities within a couple of days.

Watch this short video to find out more about how transoral outlet revision works!

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How much does the procedure cost?

You can find information on pricing on our pricing page. You can enroll in our SurgiCare Rewards Program to save money on treatments.

What are the risks associated with transoral outlet revision?

Transoral outlet revision at Ideal Body Institute is a minimally invasive procedure with a very low risk of complications.

What are the alternatives to GSRe and TORe?

There are several ways of reducing the stoma (the connection between the stomach pouch and small intestine), stomach, or pouch size.

Reduce “stoma” size: This connection can enlarge following surgery for some people. If this has happened to you, having the connection tightened can get you back on track with your weight loss.
Resize or tighten stomach pouch: If your stomach pouch has stretched over time, having it reduced can also improve weight loss. The procedures include:
- Endoscopic injection of a “sclerosant” (morrhuate sodium) to shrink the stomach. We may need to administer the injections two to three times before determining whether the process was a success.
- One study showed that 64 percent of patients lost at least 75 percent of their weight regain after their injections. The only complication that occurred was symptoms of stomal stenosis (a narrowing of the connection between the stomach pouch and small intestine) that required the stomach to be stretched out with a special balloon.
- Another study revealed that out of 231 patients who underwent 575 sclerotherapy sessions:
  - 12 months from the last sclerotherapy session, weight regain stabilized in 78 percent of the patients
  - Patients who had two or three sclerotherapy sessions had much higher rates of weight regain stabilization than those who had a single session
  - The average sclerotherapy patient lost 10 pounds in six months
  - There were ‘high responders’ who lost an average of 26 pounds, which was 61 percent of the weight regain
  - Those who had higher regain after bariatric surgery responded better to sclerotherapy
- The procedure does carry a low risk of minor complications, including bleeding (2.5 percent of patients), abdominal pain (0.5 percent), and small ulcers (1 percent) along with a relatively high risk of blood pressure elevation (11 percent). Due to the risk of blood pressure elevation, patients with cardiac risk factors should not undergo this procedure.
Convert to another operation such as sleeve-to-bypass, bypass-to-duodenal switch.