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Revision For Failed Gastric Bypass Surgery

More than 100,000 people in the United States undergo gastric bypass surgery to treat obesity(1). Generally, most gastric bypass patients achieve excellent weight loss resultsHowever, some patients experience weight regain, inadequate weight loss, and other adverse complications after their initial surgery. In these cases, bariatric revision surgery may be necessary. 

 

At the Khalili Center, we understand that a failed gastric bypass must be approached accordingly to eliminate complications and improve your quality of life. Our team of experienced surgeons specializes in various weight loss and revisional bariatric procedures.

Choosing the Best Gastric Bypass Revision Surgeon

Most revisional procedures have favorable outcomes when performed by an experienced bariatric surgeonThe Khalili Center’s team consists of highly trained and board-certified surgeons. Our clients can rest assured that we will safely perform every procedure. 

Our team is led by a well-known and highly regarded surgeon in bariatric surgery, Theodore Khalili, MD, FACS. He is also the founder of the Weight Loss Surgery of Southern California. Dr. Khalili has successfully performed over 8,783 bariatric and advanced laparoscopic surgeries, including revisional procedures. 

As a pioneer in minimally invasive surgical techniques, Dr. Khalili has written numerous papers and presentations and has spoken nationally and internationally. He has also used his expertise and vast experience in weight loss surgeries to train several surgeons, who have led bariatric care programs all over the U.S.

Alongside Dr. Khalili are other specialists in bariatric surgery, minimally-invasive surgery, robotics surgery, and general surgery. 

Our dedicated physicians believe that the best treatment options result from building a true partnership with our patients. Know more about our team of medical professionals committed to every patient’s well-being. Click here.

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My name is Dr. Theodore Khalili, surgeon and founder of Weight Loss Surgery of Southern California. I founded the Center because I have dedicated my life-long professional work to patient care. My approach to patient-centric partnerships and service-oriented facilities offer a comprehensive and holistic approach to bariatric treatment – all in one place.

I believe that patient care does not end right after surgery – it’s only the beginning. I founded the Center to give patients access to a supportive community that guides them through each step of the weight loss journey. We work with a team of registered dieticians, psychologists and general doctors to create tailored, best-in-class care available.

I have performed over 8,000 bariatric surgeries…

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Dr. Theodore M. Khalili,
Founder and Director
Khalili Center for Bariatric Care


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Is Gastric Bypass Revision Procedure for You?

The Khalili Center’s team provides you with the information you need to make a well-informed decision if a surgical revision is right for you. Through our medical evaluation, we help you determine the underlying factors that caused weight gain or lack of desired results. 

You may be an ideal candidate for gastric bypass revision surgery if you(2):

  • Experienced weight gain after initial weight loss
  • Underwent gastric bypass procedure but did not lose enough weight
  • Experienced medical complications, such as ulcer and dumping syndrome, after the weight loss surgery
  • Have unresolved conditions (comorbidities) associated with obesity, including high blood pressure, diabetes, high cholesterol, and heart disease

Insufficient weight loss or regaining of weight after a gastric bypass may result from changes in your diet, exercise habits, and other lifestyle changesHowever, the most common reason for failed gastric bypass is that the stomach pouch and the stomach outlet (stoma) can gradually stretch over time. A simple procedure, known as upper endoscopy, determines if your stomach pouch and stomach outlet may have stretched. 

A gastroenterologist performs this procedure using a small scope with a video camera to measure the stomach pouch and stomaBefore the endoscopy procedure, the gastroenterologist will coordinate with your bariatric surgeon and find out the exact measurements that need to be taken. An esophagram, an X-ray of the esophagus and stomach, is another procedure that evaluates the general shape of your anatomy. Once our surgeons at the Khalili Center have this information, we can help you determine the best and safest weight loss revision surgery.


How Gastric Bypass Revision Works

Revision surgery is a procedure that helps correct problems associated with previous weight loss surgeryIn most cases, this procedure is performed laparoscopically, resulting in faster recovery and decreased wound complications. 

There are various procedures involved in gastric bypass revision:


Distal Roux-en-Y Gastric Bypass

This minimally invasive procedure helps you lose regained weight after gastric bypass surgery by reducing your ability to absorb food and calories.

In distal gastric bypass surgery, surgeons divide a part of the small intestine (Roux-limb) from its original position and connect it to the distal (outer) part of the small intestine (about 200 cm from the end of the small intestine). 

The food is then mixed with digestive juice in the last 200 cm of the small intestine, thus decreasing the absorption of food. With less absorption, patients can lose up to 60% of their excess weight


StomaphyX

The StomaphyX is an innovative revisional procedure that reduces the size of the stomach, similar to the results of the initial gastric bypass surgery

Approved by the U.S. Food and Drug Administration (FDA), this procedure is for individuals who have had gastric bypass and have regained weight due to an enlarged gastric pouch or stomach outlet(3)

The surgeon places an endoscope (tube with a light and camera) through the mouth into the stomach pouch

The StomaphyX limits your food intake and slows the emptying of the stomach into the small intestine

This revisional procedure results in earlier satiety (feeling of fullness) and significant weight loss, without undergoing traditional surgery. 


Other Bariatric Surgery Revision Options

Aside from gastric bypass revision, the Khalili Center offers other surgical options for revisional procedures.


LAP-BAND (Adjustable Gastric Banding)

This procedure involves placing a lap band around the top part of the stomach. The adjustable gastric band device separates the stomach into two compartments, resulting in a patient eating enough food to fill the stomach’s top part. The FDA indicates LAP-BAND for use in severely obese adult patients with a body mass index (BMI) of 40 and above and have failed in other weight reduction alternatives(4).

If needed, the lap band is adjustable and can be altered to restrict food intake. The lap band also may require adjustments over time, which are performed laparoscopically. After this gastric banding surgery, the stomach’s upper small pouch can hold only about half a cup of food. Patients will feel full faster and satisfied longer. 


Sleeve Gastrectomy

Sleeve gastrectomy, also known as gastric sleeve surgery, is a laparoscopic procedure that involves removing about 80% of the stomach. Surgeons create a tube-like pouch or gastric sleeve that empties food off the bottom of the stomach and into the small intestine

This procedure results in a smaller stomach and lessens your desire to eat due to a change in hormones affecting the appetite. Patients who have had initial gastric sleeve surgery may also be a candidate for re-sleeve surgery. However, it is best to consult with our surgeons to know if this procedure is appropriate for you. 


Preparing for Gastric Bypass Revision

During your initial consultation, one of our surgeons will confirm if you are a potential candidate for gastric bypass revisional procedures. Once you are qualified, you will undergo a series of diagnostic tests to ensure that you are well-prepared for the surgery. Our team will thoroughly explain the steps involved in the preoperative process.

We also recommend checking with your primary healthcare provider if they can cover the tests’ costs. 


Post-surgery Expectation

Generally, you can go home two to three days after your revision surgery. You must refrain from eating solid foods to allow your stomach and digestive system to heal. You must follow a liquid diet during the first week or two, then followed by soft foods. Drinking water will not stretch your pouch after surgery as the liquids pass directly through your digestive system. 

You will also receive prescribed medications directed for pain and acid reflux. We do not recommend taking non-steroidal anti-inflammatory drugs (NSAIDs) as they increase your risk of developing ulcers(5). Ulcers are more challenging to diagnose and treat after a bariatric procedure

A week after the procedure, you should be ready to go back to work and engage in non-strenuous physical activities. Most patients at the Khalili Center experience a smooth recovery time. However, it is best to consult and inform your doctor if you observe regurgitation, nausea, constipation, or diarrhea. We encourage healthy lifestyle changes, such as developing exercise habits and following a balanced diet to achieve long-term weight loss.

Recovering From Gastric Bypass Revision

The Khalili Center offers a unique care support program tailored to your needs. We believe that support can greatly contribute to the success of your weight loss goals.

Our holistic and fully-integrated aftercare program consists of follow-up consultations, ongoing education (in-person and online), fitness, nutrition, support, and community activities.

Our unique care support starts with a private nutrition counseling session with our registered dietitian. Our psychologist offers a private psychological counseling session to prepare patients for life after surgery. 

We encourage our patients to attend our support groups to learn from other weight loss surgery patients and build relationships.

To keep them active, we plan several special events, including morning walks, annual softball games, and spinning events with the doctors. These programs are designed by the Khalili Center to empower and help you regain control of your life. 

FAQs

What are the Risks of Gastric Bypass Revision Surgery?

As with any weight loss procedure, there are potential complications and risks associated with revisional surgeryAfter the surgery, most patients have more frequent bowel movements. Others may develop diarrhea. 

In rare cases, there may be an infection, bleeding, and leaks in the gastrointestinal tract. There may also be risks of malnutrition and excessive weight loss due to the malabsorption of nutrients. 

At the Khalili Center, we take extra precautions in every revisional procedure that we perform. Despite the low complication rates, we still want you to be well-informed of the potential risks.

What is the Cost of the Revision Procedure?

The Khalili Center’s procedures are eligible for payment plans. We also offer free insurance verification to know if your insurance policy provides coverage for the surgery. 

Our medical center’s team is ready to assist you with any inquiries, appointment requests, and health information you may need. 

Experience the Khalili difference and connect with us at 310-246-9083.

References

  1. University of California San Diego Health. (Accessed 2020). Gastric Bypass Revision. Retrieved from: https://health.ucsd.edu/specialties/surgery/bariatric/weight-loss-surgery/bypass-revision/Pages/default.aspx
  2. UCLA Health. (Accessed 2020). Gastric Bypass Revision. Retrieved from: http://surgery.ucla.edu/bariatrics-gastric-bypass-revision
  3. Overcash, W. T. (2008). Natural orifice surgery (NOS) using StomaphyX™ for repair of gastric leaks after bariatric revisions. Obesity surgery, 18(7), 882-885.
  4. The LAP-BAND® Adjustable Gastric Banding System Summary of Safety and  Effectiveness Data. (2001, June 5). Retrieved from https://www.accessdata.fda.gov/cdrh_docs/pdf/P000008b.pdf
  5. University of California San Francisco Health. (Accessed 2020). Life After Bariatric Surgery. Retrieved from: https://www.ucsfhealth.org/education/life-after-bariatric-surgery

The Best Weight Loss Surgery, Lap Band (Band Over) Bypass Surgeons
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