Revision Weight Loss Surgery; Is It Worth The Risk?

More and more bariatric patients are seeking revision operations than ever before.  This is from a combination of reasons, including poor initial surgery choice, poor surgical technique during their primary operation, or simply because the surgical options and support at the time they initially had surgery were not adequate for them to succeed.  Regardless of the reason, revision bariatric surgery carries with it a higher risk than a primary bariatric operation.  Is this risk worth taking, for both the patient and the surgeon?

Bariatric surgery has changed dramatically over the years.  Newer, safer, and more successful operations are currently offered compared to when bariatric surgery was first performed.  In addition to newer and more successful operations, we as clinicians for bariatric patients have gained a much better understanding of what it takes to be successful after weight loss surgery.  We also are so much more engaged in a patient’s aftercare compared to just 20 years ago.  There has been a tremendous influx of new surgeons joining the bariatric surgery field in the last fifteen years, which equates to many more surgeries performed. This fact also raises the risks for poor outcomes and the need for a revision procedure.  Unfortunately, a great majority of patients that did have surgery even five to ten years ago have suffered weight regain due to a poor operation.  Bariatric revision operations are at an all time high.

So why are bariatric surgery revisions done and what should you, as a patient, consider when contemplating a revision operation?

Most revisions are done for the following reasons:

1) Weight regain

2) Failure to lose weight

3) Technically inadequate primary operation

4) Outdated primary operation with weight regain

5) Complications from their primary operation.

When considering a revision bariatric operation, the following are things to keep in mind:

1) Can a revision be done over your current operation; i.e. Do you have an operation that can be revised?

2) Revision operations carry a much higher surgical risk (morbidity & mortality) than primary operations,

3) Can you have a revision; i.e. Will your insurance cover a second procedure or can you afford to pay for a second operation?

4)  Do you medically/surgically qualify for a revision operation (body mass index, insurance pre-requisites, current medical co-morbidities, etc…)

5) What are the long term risks/side effects of the operation I am looking to convert or revise to?

6) Can I find a surgeon who will agree to perform the revision operation?

Bariatric surgery can have a significant medical, emotional, and psychological impact on a person’s life.  This type of life altering change can cause patients to pursue weight loss surgery at all costs.  Unfortunately, there are times when the outcome is not as expected, and the patient needs to consider altering, or revising his/her original operation.  What is also unfortunate is that patients don’t have a trial period with each of the surgical options available and they must commit to one operation.  What might be a great operation for one patient, may be a very poor operation for another.  It is up to the patient to do research on what operation may be the best, and then discuss this with their surgeon.  If a revision needs to be done, it is even more imperative to research the possible alternative(s), discuss these alternatives with an experienced surgeon who performs revisions regularly, and weigh out the risks versus benefits of having a revision.  At New You Sleeve, our surgeons have performed well over 10,000 primary bariatric operations along with thousands of revision operations, while still maintaining a significantly lower than average complication rate.  If you’re looking to have weight loss surgery for the first time, or you need an experienced program to discuss a revision operation, New You Sleeve can help you achieve the success you deserve.