Q: What are the reasons to consider revision surgery?

There are many reasons why you may wish to consider revision surgery after having undergone bariatric surgery in the past. The commonest reasons include:

• To correct complications as a result of previous bariatric surgery
• To address inadequate weight loss
• To address weight regain after successful weight loss

Q: What are the types of revision surgery following a gastric band?

Common reasons for requiring revision surgery following a gastric band insertion include:

• slippage of the band
• erosion of the band into the stomach
• infection of the band
• development of acid reflux
• difficulties with swallowing
• pain
• problems with the inflation port
• inadequate weight loss and
• weight regain

Both sleeve gastrectomy and gastric bypass are procedures which may be undertaken to correct issues related to the band. There are many factors which need to be taken into consideration when deciding which options are most suitable. This will be explained to you during your consultation with Mr Alkhaffaf. Thorough investigation to clearly understand the underlying cause of any issues related to your band will be considered and undertaken if necessary. Support from our experienced weight-loss team is an important aspect of revision surgery, particularly in cases of weight regain or inadequate weight-loss.

Q: What are the types of revision surgery following a sleeve gastrectomy?

Common reasons for requiring revision surgery following a sleeve gastrectomy include:

• leakage (or non-healing) at the staple line
• stricture (or a tight narrowing of the stomach tube)
• development of acid reflux
• inadequate weight loss and
• weight regain

Both the gastric bypass and mini-gastric bypass are procedures which may be suitable to correct problems following a sleeve gastrectomy. There are many factors which need to be taken into consideration when deciding which options are most suitable. This will be explained to you during your consultation with Mr Alkhaffaf. Thorough investigation to clearly understand the underlying cause of any issues related to your sleeve gastrectomy will be considered and undertaken if necessary. Support from our experienced weight-loss team is an important aspect of revision surgery, particularly in cases of weight regain or inadequate weight-loss.

Q: What are the types of revision surgery following a gastric bypass?

Common reasons for requiring revision surgery following a gastric bypass include:

• stricture (or a tight narrowing of the join between the stomach and bowel)
• chronic stomach ulcers
• inadequate weight loss and
• weight regain
• excessive weight loss or nutritional deficiency

Strictures of the joins between the stomach and bowel may require stretching (dilatation) using a gastroscopy under sedation. Chronic ulceration of the stomach pouch may occasionally require further surgery to enable healing. In cases of weight regain or inadequate weight loss, it may be possible to place a gastric band around the stomach pouch to improve weight-loss. Where there has been excessive weight-loss or nutritional deficiencies which cannot be managed medically, it may be possible to reverse the bypass.

There are many factors which need to be taken into consideration when deciding which options are most suitable. This will be explained to you during your consultation with Mr Alkhaffaf. Thorough investigation to clearly understand the underlying cause of any issues related to your gastric bypass will be considered and undertaken if necessary. Support from our experienced weight-loss team is an important aspect of revision surgery, particularly in cases of weight regain or inadequate weight-loss.

Revision surgery is safe and effective and the risks associated with it are small.  However, compared to primary or ‘first-time’ surgery, the risks of developing certain complications because of existing scarring (adhesions) or infections are slightly higher. These include poor healing and leaks from the staple line which can require additional treatments including a return to the operating theatre and prolonged stays in hospital. Due to the unpredictability of revision surgery, it may be necessary to change the agreed surgical plan during the operation. In some cases, it may not be possible to undertake any type of revision weight-loss surgery at all. All these risks will be carefully explained to you by Mr Alkhaffaf during your consultation.

Q: How can I get the best result from revision surgery?

Revision surgery is a complex specialty which requires a careful work-up by an experienced team. To get the best results out of revision surgery, it is extremely important to engage with the bariatric team to address underlying factors which may have contributed to the need for revision surgery. These will be fully explained to you during your consultation with Mr Alkhaffaf, the bariatric nurse, dietitians and pyscho-therapist. Weight-loss surgery is a tool and its success is heavily influenced by your genes and the lifestyle choices you make.

Q: How much does revision surgery cost?

The cost of revision surgery reflects the complexity and the additional operating time required compared to primary or ‘first-time’ surgery. Revision surgery may also require a longer stay in hospital, the need for high dependency unit (HDU) care, different post-operative medication, specific blood tests and other investigations. These factors will impact on cost which cannot be compared to primary surgery e.g. a ‘band-to-sleeve’ revision surgery will cost more than a primary sleeve gastrectomy. A full breakdown of costs will be provided to you following your initial assessment and consultation with Mr Alkhaffaf.