What procedures may be used if I need revision obesity surgery?

There are several procedures that may be used if you need revision surgery for a previous weight loss procedure. These include:

• Adjustable banded gastric bypass as a revision of gastric bypass. For patients who experience weight gain after gastric bypass, surgeons at the center have developed a procedure in which an adjustable band is placed on top of their bypass, allowing control of the size of the stretched tissue and offering the option to tighten the band in to prevent weight gain. This procedure may have less risk than other revisional options.

We also convert failed gastric bypass to duodenal switch.

• Banded gastric bypass as a revision of gastric banding. If you originally had a gastric banding procedure, weight gain may occur if the band slips or if you have trouble tolerating the tightening of the band. Surgeons at the center can reposition the band, or they can add a gastric bypass, leaving the band in place, a procedure created by surgeons at the center. This allows doctors to operate on a fresh portion of the stomach rather than a scarred area, and save the adjustability of the band to enhance the overall results. Because the procedure does not involve stapling over scarring, it offers the effects of a bypass without the risks of revision surgery.

We also convert vertical banded gastroplasty into banded gastric bypass.

• Endoscopic sclerotherapy. Another option your doctor may choose is to tighten tissue that has stretched following gastric bypass. This is accomplished by scarring the opening between the stomach pouch and the intestine through injection of an acidic solution (this technique is also known as sclerotherapy). The scarring narrows the opening, slowing the exit of food from the stomach pouch, and enabling patients to better restrict food intake. This procedure can be performed using a scope placed through the mouth, avoiding further incisions.