Revisional bariatric surgery is performed to alter or repair a preexisting operation for treatment of morbid obesity. In light of the increasing number of surgical procedures performed, the need to revise and correct operations is also on the rise.
NJ Bariatrics is one of the only weight loss surgery centers in the tri-state area with bariatric surgeons skilled enough to perform revisional bariatric procedures.
Questions About Revisional Surgery
Absolutely. Revisional bariatric surgery is one of our specialties, so it’s quite common for our patients to have received their first bariatric operation from a different operating surgeon.
There are two:
- Poor weight loss or weight regain.
- Complications of the original procedure. These are generally procedure-specific, e.g., ulcers for RY gastric bypass, slippage for the LAP-BAND, etc.
In general, the coverage by insurance providers for revisional bariatric surgery mirrors that of the primary procedure, e.g., if you’re 100 pounds over your ideal weight or you have significant obesity-related health problems. Many insurance companies require another diet history.
If you’re suffering from complications related to your original procedure, often you’ll be quickly approved for surgery due to the medical necessity of your condition. However, those with unsatisfactory weight loss as the reason for their revision may have more difficulty getting approved, depending upon their insurance carrier.
No. Regaining a small amount of weight is common following all bariatric operations. The key is to limit the amount of weight gain.
If weight control becomes a problem again, you should seek out your original bariatric surgeon for evaluation. Additionally, we’d be happy to answer any of your questions. Contact us for assistance.
The results can vary widely.
In the hands of an experienced bariatric surgeon, the results of operations for complications are generally good. This means that the complication is corrected and the associated problems are resolved. Weight loss following revisional procedures is generally less dramatic than following the primary operation. This is primarily because patients who have revisional surgery for a failure to lose weight have considerably more difficulty losing weight in general.
The results also depend on the original bariatric procedure. Many patients who have failed to lose significant weight after undergoing the LAP-BAND procedure have fairly good weight loss after a conversion to Roux-en-Y gastric bypass. Conversely, patients who fail gastric bypass tend to lose less weight following conversion to a more malabsorptive bariatric procedure. Additionally, patients who have “popped” their staples usually do well when the situation is repaired.
Historically, revisional bariatric surgery has been high-risk. Two decades ago, the overall complication rate approached 50% with a mortality rate as high as 5-10% in some published reports.
However, during the past 10 years these results have improved. It’s generally accepted that revisional bariatric procedures should NOT be performed by surgeons with little or no bariatric experience. Several recent publications emphasize that a surgeon’s experience is directly related to better outcomes.
In short, the best results following revisional bariatric operations are obtained by the most experienced surgeons. This is the primary reason why NJ Bariatrics offers revisional surgery. Dr. Robert Brolin is among the most experienced bariatric surgeons practicing today. Additionally, Dr Brolin has one of the largest series of revisions for failed gastric bypass in the world.
After contacting us to schedule a consultation for revisional surgery, please gather and bring the following items to your first appointment:
- Old operative report detailing how the first surgeon performed
- Most recent UGI contrast study
- Most recent upper endoscopy (EGD) reports
- Results of recent laboratory (blood) tests
- Completed patient questionnaire
- Insurance card
- Photo ID
Dr. Brolin currently has the largest published experience with revisonal surgery for ulcers in the world, and the second largest published personal series of revisions (all types) in the world.
If you’re considering revisional bariatric surgery, we can help you get started.
Other Frequently Asked Questions
For general questions and answers about bariatric surgery and recovery, click here.