Revision Surgery

Procedures to Correct Previous Bariatric Operations

What is Revision Surgery?

Revisional bariatric surgery offers three potential options to address issues with previous weight loss surgeries:

Conversion: Changing the type and/or mechanism of the initial surgery. The most common reason for conversion is weight loss failure.
Revision: Adjusting parts of a prior surgery without altering its overall type. This is often done due to weight loss failure or surgical complications.
Restoration: Restoring the patient's normal anatomy. This option is typically considered when complications arise.

How Common is Revision or Conversion Surgery?

Revision surgery is becoming increasingly common. According to scientific studies, the global revision rate for bariatric surgery ranges from 5% to 56%, depending on various factors and patient conditions.

When is Revision of a Previous Surgery Necessary?

A “rescue” operation—or re-intervention—is always a possibility when initial procedures do not yield the desired outcomes. A thorough evaluation by the surgeon and a multidisciplinary team, including a psychologist, is essential to understand why the initial surgery did not succeed. Reasons for failure may include:

Lack of physical activity
Failure to adopt healthier eating habits
Not following the post-operative care plan
Inadequate chewing or eating too quickly
Stretching of the gastric pouch or bypass over time

Each patient’s journey is unique, and a collaborative approach ensures the best path forward. Patient commitment is vital for the success of any bariatric surgery. For patients with severe obesity, a return to a healthier lifestyle, including the Mediterranean diet, is often recommended. Success depends on the patient’s willingness to adopt these dietary changes, as surgery alone cannot ensure long-term weight loss.

Patient commitment is vital for the success of any bariatric surgery.

For patients with severe obesity, a return to a healthier lifestyle, including the Mediterranean diet, is often recommended. Success depends on the patient’s willingness to adopt these dietary changes, as surgery alone cannot ensure long-term weight loss.

Can Complications After the First Surgery Indicate the Need for Revision Surgery?

Yes, complications can sometimes signal the need for revision surgery. These may occur early (within 1-3 months post-surgery) or late (from three months to several years).

Surgical complications depend on the type of initial procedure and may include mechanical issues. These are often unrelated to the effectiveness of the surgery itself.
Non-surgical complications may arise from nutritional deficiencies or poor adherence to the post-operative rehabilitation plan.

Can Some Patients Be Resistant to Weight Loss?

Though rare, some patients may experience resistance to weight loss even after undergoing primary or revision bariatric surgery. This resistance can be due to various factors and requires a tailored approach.

What Should Patients Know About Complications After Revision Surgery?

Revisional procedures carry a higher risk of complications compared to primary bariatric surgery. Therefore, it is crucial for patients to seek care from highly specialized centers certified by the Italian Society for Bariatric Surgery (SICOB). Choosing a certified center ensures the highest level of expertise and care.