Revisional Surgery

The surgical treatment for failed or dysfunctional weight loss operations.

What you need to know about Revisional Surgery

Revisional bariatric surgery is the surgical treatment for failed or dysfunctional weight loss operations. There are several reasons why patients may seek out revisional bariatric surgery. For some, a weight loss procedure may yield less-than-optimal results, either through inadequate weight loss, inadequate resolution of co-morbidities or by medical complications specifically related to their weight loss surgery.

The decision to undergo revisional bariatric surgery is not one to be taken lightly. As in any other procedure, the decision lies in weighing the risks against the benefits. Revisional bariatric procedures are higher risk than first-time bariatric procedures. They are typically longer procedures, often, but not always, through open incisions with greater blood loss and a higher incidence of leak and infection. The higher leak rate is thought to be a result of microscopic changes in blood flow to the stomach, induced by the original surgery.

The Result

While there are times revisional bariatric surgery is medically necessary and beneficial, revisional procedures are best approached on a highly individualized basis, tailoring weight loss surgery to the patient's unique and specific needs.

Sometimes, results of revisional procedures done to further weight loss are less than optimal because weight loss results of revisional surgeries do not seem to be as high as when the surgery was performed as a first-time procedure. This phenomenon is metabolic in nature – the body appears to undergo metabolic adaptation to the first bariatric surgery, making subsequent weight loss more difficult. Further, patients who are particularly metabolically stubborn are more likely to fail a first-time weight loss procedure in the first place.

Other Facts

• Higher risk than first time bariatric procedures
• Varied weight loss results
• Subsequent weight loss is more difficult