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Why Is Revision Surgery Sometimes Needed After Weight Loss Surgery

revision surgery

Bariatric surgery results in high levels of long-term weight loss. Depending on the procedure that the patient has, most will experience around 70% of excess weight loss within the first two years. Alongside incredible weight loss, gastric surgery can help with serious health conditions such as PCOS, Type 2 diabetes and sleep apnea. 

While most patients who undergo weight loss surgery will maintain their weight loss for long into the future, for some, revision surgery is necessary. A weight loss revision procedure is only needed for a small percentage of patients and can be for a number of reasons.

Mr Rishi Signhal says “As a bariatric surgeon, revision surgery is the surgery I enjoy most. We never know quite what to expect as it’s impossible to know what state the abdomen will be in following the primary procedure. I see an increasing number of patients in clinic who want revision and I expect the trend to continue. Thorough pre-operative assessment, focusing surgery on only those surgeons who do a lot of cases and paying careful attention to outcomes are important attributes of the Healthier Weight programme.”

What Is Revision Surgery?

As more people have weight loss surgery, it’s inevitable that more people will need revision surgery. This is the term we use when referring to the surgery that either corrects a problem with the first weight loss (primary) procedure or that converts the primary procedure into something more powerful (possibly a gastric band to gastric bypass revision).


Gastric Band to Gastric Bypass Revision Surgery

Gastric band surgery is the safest form of weight loss surgery, but for some, it is not the most powerful. We expect most band patients to lose 50-60% of their excess weight in the first 2 years. 

For some gastric band patients, after years with the band, they could still see some regain. And while this could be dealt with by appointments with a nutritionist or health coach, or more band fills, there might be a better option with revision surgery. 

In the band to bypass conversion, the surgeon will remove the gastric band and perform a bypass on the patient. This is keyhole surgery so will be minimally invasive. 

More about the band to bypass revision here


When To Know If Revision Surgery is for You?

Before considering weight loss revision surgery for anyone we would need to establish that you have made every effort to succeed with your primary procedure and that the potential to get this procedure working without the need for more surgery has been exhausted. This is most common in gastric band

Our guidelines for patient selection are broadly in line with those published by the National Institute for Health and Clinical Excellence (NICE).

Where they differ, it is because the financial pressures that apply in the NHS do not apply with patients who are privately funding their procedure. Where the NHS is concerned, the ‘national health benefit’ of surgery needs to be balanced with the cost. When patients fund their procedure themselves, the cost balance doesn’t apply. This is why the BMI criteria that apply in the NHS will be higher than those that apply when a patient opts for a private procedure. You are eligible for revision surgery with us when:

  • You have a body mass index in excess of 35 (this limit may be reduced for those with type 2 diabetes and those with Asian/African ethnicity – due to increased Diabetes risk), you have attempted to work with your primary weight loss procedure and you are gaining weight, or
  • You have a body mass index above 30 and you are experiencing a complication with your primary procedure that necessitates surgical revision for safety reasons.

We occasionally find that incorrect adjustment of the gastric band, or poor aftercare, was the reason for failure. The band or access port may also be leaking given the impression of failure, when in fact the problem is mechanical (and not with the patient). In cases like this, we would always attempt to get the band working as it should before undertaking more surgery.

If you are interested in a gastric procedure such as the gastric band, gastric sleeve, gastric bypass or ESG. You can contact our expert team today and book a free consult with one of our weight loss surgeons.


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