Although gastric bypass is considered the gold standard among all bariatric surgery procedures, a small percentage of patients will experience weight loss failure, weight regain, or medical complications. These issues are usually corrected with a gastric bypass revision surgery. During your initial consultation with a weight loss surgeon, make sure to discuss all the pros and cons of the procedure and request them to show you a few gastric bypass revision before and after photos.
RNY revision surgery is a complex procedure, so your surgeon should have the required training and experience to perform it safely and deliver the desired results. Check out the surgeon’s past track record of performance and review the gastric bypass revision success stories of previous patients, if you can find them online. If it is done right, a bariatric revision surgery can be life-changing. It will help restore your healthy body weight and resolve medical complications.
What is gastric bypass revision surgery
Gastric bypass revision surgery is a secondary bariatric procedure that may be performed if your primary gastric bypass has failed. While there is no standardized Roux-en-y revision technique, your surgeon will evaluate a few RNY revision options before recommending the right procedure for you. They will consider the reasons why your original surgery failed, and examine your current health complications and BMI levels.
How is a Revision Performed?
When you discuss with your bariatric surgeon about what is a gastric bypass revision and how it will be performed, they will explain to you the various steps involved in your procedure. You may have a number of Roux-en-y revision options, ranging from highly invasive to minimally invasive. For instance a gastric bypass to duodenal switch conversion will be a major surgery involving significant recovery. On the other hand, an innovative StomaphyX surgery will not require incisions or overnight hospital stay.
Benefits of a Revision Surgery
Here are some of the key advantages of a Roux-en-y revision surgery:
- Gastric bypass revision success rates are high, so you can expect to achieve freedom from obesity
- Some of the persistent obesity-related complications such as type 2 diabetes may be resolved with a revision surgery
- If you choose a minimally invasive revision technique, you may have additional scarring or go through any significant downtime
- In some cases, the gastric bypass revision cost may be lower than the primary procedure, if a less invasive technique is used
- Almost all major health insurance providers offer coverage for gastric bypass revision surgery
Reasons for roux en y gastric bypass revision
RNY revision surgery is typically performed when your primary gastric bypass failed to produce sufficient weight loss, or you regained the weight fairly quickly. In some cases, the primary surgery may cause medical complications, necessitating a revision procedure. Let us look at all these causes in some detail.
- Weight Loss Failure: This is one of the most common reasons for gastric bypass revision. If you did not abide by your surgeon’s post-operative dietary and fitness guidelines following your primary surgery, you may fail to lose the desired amount of weight. In a few cases, weight loss failure may also occur if your original bariatric surgeon did not reduce your stomach size sufficiently or did not reroute the small intestine correctly.
- Weight Regain: Weight regain after a primary gastric bypass may usually occur after a year or two when you become lax with your prescribed post-op diet. It is also possible that a chronic condition such as thyroid might aggravate at some stage and contribute your weight regain. If you regained a substantial amount of weight that you initially lost, you may be a candidate for a gastric bypass revision.
- Medical Complications: A gastric bypass is considered the most effective surgery to resolve your obesity-related health complications, such as diabetes, hypertension, sleep apnea, and fatty liver disease. However, depending on your metabolic condition and other factors such as genetics and dietary and lifestyle choices, your medical complications may persist after surgery or new complications may arise. In these conditions, you may require a Roux en y gastric bypass revision.
Related: Gastric bypass complications
Gastric bypass revision surgery options
With advancements in bariatric techniques, a number of Roux en y revision options are available today. While some bariatric surgeons may recommend options such as placement of an adjustable gastric band, these measures may not produce sustainable benefits. Here are four clinically proven and highly effective gastric bypass revision options.
Endoscopic Gastric Bypass Revision
An endoscopic RNY revision is a minimally invasive procedure that involves no internal or abdominal incisions. Your surgeon will insert a tiny endoscope orally into your stomach pouch, which will show them the internal structures on an external monitor. The surgeon will do revised stomach suturing and rerouting of your small intestine to reduce your calorie absorption. While you may require general anesthesia for this procedure, you can recover fast with minimal risk of complications.
Distal Gastric Bypass Revision
According to some of the top-rated surgeons and hospitals, a distal gastric bypass revision surgery technique can produce more substantial and durable weight loss than an endoscopic revision. This procedure is performed using a laparoscope and will involve minor abdominal incisions. In a distal procedure, the surgeon will reconnect your gastric pouch close to the end of your small intestine (leaving a gap of only about 200 cm). As a result, your calorie absorption will significantly reduce further.
Gastric Bypass Conversion to DS
Gastric bypass conversion to duodenal switch (DS) surgery is a proven and advanced procedure that will create the largest amount of weight loss. It is also considered to be the most effective when you need to mitigate type 2 diabetes symptoms. Unlike your primary gastric bypass surgery, in this revision procedure a larger part of your bowel will be bypassed so that only a small amount of calories will get absorbed in your body through the small intestine. You will need regular nutrient supplementation after this surgery.
Related: Gastric sleeve vs. duodenal switch
Gastrojejunal Anastomosis Revision
In rare cases, the primary gastric bypass may result in the development of marginal ulcers around the gastrojejunal anastomosis. If you need gastric bypass revision due to ulcer, your surgeon may recommend this technique. The surgeon will first attempt to correct your condition with medical therapy, but if the ulcers have become resistant to medications, the gastrojejunal anastomosis revision surgery may be performed. Make sure your surgeon has the training and experience to perform this complex procedure.
How to qualify for gastric bypass revision
Many patients who are struggling to achieve their post-surgical weight loss goals may be anxious to know how to qualify for gastric bypass revision. However, this major revision surgery is not for everyone. Your surgeon will first evaluate whether your weight loss and health can be restored by going back to a balanced lifestyle and following a revised post-op diet plan. However, you may qualify for a gastric bypass revision in the following circumstances.
- Severe Complications: If your primary bariatric surgery was not performed correctly or you developed post-operative complications like an infection or stomach or intestinal perforation, it may be necessary to perform a corrective revision bypass procedure. Alternatively, if your chronic obesity-related medical complications, such as diabetes have flared up or returned from remission, you may qualify for a revised gastric bypass.
- Massive Weight Regain: You may qualify for a gastric bypass revision surgery even years after your primary bariatric surgery. Sometimes the weight regain will occur slowly, and you may fail to notice it if you are not keeping a careful track of your daily diet and your body weight. It may be too late to reverse the condition through natural means if you have ignored the signs of weight regain for long. If your BMI is again above 40, your surgeon may recommend a weight loss revision surgery.
- Minimal or No Weight loss: If you have experienced total weight loss failure despite maintaining a balanced diet in line with your nutritionist’s advice and an active lifestyle, the reason could be that your gastric pouch may have expanded or the intestinal rerouting may be inadequate for calorie control. In this situation, your gastric bypass surgeon may consider you as a qualified candidate for an RNY revision procedure.
Gastric bypass revision cost
The gastric bypass revision cost in the US or Canada is currently in the range of $20,000 to $30,000 on average. You may also consider an equally competent but far more affordable option of medical tourism to Mexico for this surgery. Gastric bypass revision cost in Mexico may range from $7,000 to $10,000 on average. In other words, in Mexico you may only have to about one-third of the cost you might pay in your home country for this procedure.
Another advantage is that unlike most hospitals and surgery centers in the US or Canada, the leading hospitals in Mexico will usually cover most of your surgery-related expenses within this cost. Your gastric bypass revision cost in Mexico may include the following items:
- Fee of the bariatric surgeon
- Fee of other attending surgeons or specialists
- Anesthesia team charges
- Operating room costs, including overnight hospitalization
- Pre- and post-operative consultations with the surgeon
- Consultation appointment with the nutrition and physical therapist
- Fee of the aftercare nurse coordinator
- Pre- and post-op blood work and diagnostic tests, such as EKG
- Prescription medications for a week
- Ground transportation to and from the airport
Average weight loss after gastric bypass revision
The average weight loss after gastric bypass revision for most patients will be about 70 percent at 12 months after the surgery. This is just an average figure, but individual results will vary. Some people may lose more weight than this range, while some others may lose less weight. Factors such as your age, health condition, primary bariatric surgical history, post-op complications, and past events such as weight loss failure, plateau or regain will make a difference.
- Weight Loss at 3 Months: The average weight loss after gastric bypass revision surgery will be most rapid in the first three months. During this period, you might lose up to one-third of your total excess weight.
- Weight Loss at 6 Months: You may expect to lose around one to two pounds per week in the period between three to six months after your revision surgery. The median weight loss would be about 35 pounds at this stage.
- Weight Loss at 12 Months: It is possible to lose up to 70% of your excess weight by the end of first year. Remember that this is the best case scenario, and even if you lose only about 50 to 60% of your excess weight by this time, you are still winning.
- Weight Loss at 24 Months: Your goal should be to completely eliminate obesity and restore your ideal body weight at 24 months. However, on average, people may lose up to 80 to 85% of their excess weight at two years.
Related: Weight gain after gastric bypass
Recovery time for gastric bypass revision surgery
Recovery time for gastric bypass revision surgery will be about one to two weeks on average. During your pre-op consultation, you should freely discuss with your bariatric surgeon about the estimated downtime and the do’s and don’ts to follow during your recovery process. Schedule your surgery at a time when you can focus on recovery without any stress or anxiety of work and allow your healing to be thoroughly completed.
Factors that will Affect Recovery Time
Recovery time for gastric bypass revision can vary between patients because of the following factors:
- Age and general health condition
- Type of medical complications
- Patient’s natural ability to heal
- Type of gastric bypass revision surgery technique used
- Commitment to gastric bypass surgeon’s recovery guidelines
- Whether the patient is a non-smoker
- Skill and experience of the operating surgeon
Expected Post-Op Recovery Timeline
As long as you follow your surgeon’s recovery instructions, you may expect to recover as per this timeline:
- Week 1: Rest and recuperate at the hotel room for most of the week.
- Week 2: Perform light activities, continue with the post-op liquid diet
- Week 3: Return to the workplace, but do only sedentary desk jobs
- Week 4: Swelling would largely resolved, resume mild fitness regimen
- Month 2: Increase physical activities, but avoid vigorous exercises
- Month 3: Return to a fully active lifestyle and join the gym
Related: Gastric bypass results
Diet after gastric bypass revision
Diet after your RNY revision surgery is one of the most crucial factors that will determine your long-term weight loss success. Your surgeon and their nutritionist will provide you with a detailed post-op gastric bypass revision diet program. Your goal should be to diligently pursue the prescribed diet plan and maintain ideal dietary practices for a lifetime.
- Liquid Diet: About two days prior to your Roux en y revision surgery and two weeks afterwards, you will have to follow a 100% liquid diet. This may include protein shakes, clear soups, fruit juices, and hot cereals. In the second week, you can move on thicker soups, shakes and sugarless yogurt.
- Pureed Diet: This diet will continue in the third and fourth weeks after your gastric sleeve revision surgery. You can choose liquids with a thick consistency, such pureed turkey, beef, chick, low fat cheese, mashed white fish, and scrambled eggs. Focus on high protein content in the pureed diet.
- Adaptive Diet: Soft and adaptive foods will be introduced to your RNY revision diet in the second and third months after the surgery. Your diet will include cooked vegetables, cereals, fish, chicken, cereals, fruit and chopped meats in semi-sold form. Do not miss your nutrition supplements with your diet.
- Solid Diet: Once the first three months of your Roux en y revision surgery are over, you can gradually move on to a normalized, solid diet. Eat all kinds of healthy foods, and continue to avoid fatty, processed, and sugary foods. Focus on nutrient-dense foods for maximum health benefits.
Gastric bypass revision success rate
Gastric bypass revision success rate is about 90 percent, both in terms of weight loss success and improvement or resolution of obesity-related medical conditions. Interestingly, this success rate is significantly higher than that of the primary gastric bypass. Here are some of the reasons why the RNY revision success rate is higher.
- Gastric bypass revision will substantially reduce stomach size
- Some of the revision techniques will drastically reduce calorie absorption in the small intestine
- The less invasive revision techniques may produce slower weight loss, but the rate of complications is much lower
- Gastric bypass revision surgery is usually performed by highly qualified and experienced surgeons only who have a high success rate
- Patients are often much more committed and carefully about following post-op diet plan and other instructions because it is their second bariatric surgery and they know it is their last chance
Related: Gastric bypass revision success rate
Gastric bypass revision complications
Gastric bypass revision surgery complications are relatively fewer because the patients are usually more cooperative and only skilled bariatric surgeons will perform this procedure in most cases. Nevertheless, it is important to be aware of the potential gastric bypass revision complications, side effects and risks in order to make an informed decision.
Short Term Complications
- Poor anesthesia reaction
- Infection in the incision sites
- Stomach obstruction
- Acid reflux or GERD
- Nausea and vomiting
- Esophagus dilation
- Weight loss failure or weight regain
Long Term Complications
- Low blood sugar
- Dumping syndrome
- Bowel obstruction
- Stomach stenosis
Other Potential Complications
- Stomach or intestine perforation
- Internal bleeding
- Stomach leakage
- Anastomotic obstruction
- Pulmonary complications
- Skin separation
- Spleen injury
Related: Gastric bypass complications
Gastric bypass revision before and after success stories
Many patients are naturally reluctant to go ahead with their gastric bypass revision surgery because their primary surgery has disappointed them with weight loss failure or created medical complications. But if they are appropriate candidates for a revision surgery, the bariatric surgeon should encourage them by sharing gastric bypass revision before and after success stories of past patients.
This can help restore the patient’s confidence that revision procedure will only benefit their health and well-being and improve their quality of life. A responsible surgeon may also present gastric bypass revision before and after pictures of past patients. This will enable a new patient to develop realistic expectations and approach the procedure with a positive mindset.
Gastric bypass revision surgery in Mexico vs USA
Are you wondering whether it is worth choosing your gastric bypass revision surgery in Mexico instead of the US? Thousands of women and men are benefitting from all types of bariatric surgery procedures in Mexico every year. Here are a few reasons that should help you make up your mind about going ahead with your gastric bypass revision in Mexico.
- Gastric bypass revision cost in Mexico is a small fraction of what you might end up paying in the US
- Bariatric surgeons in Mexico are as qualified and experienced as anywhere else in the world, including the US
- Hospitals and bariatric surgery centers in Mexico are equipped with state of the art surgical facilities and full-service options
- Surgeons in Mexico will provide you personalized care and attention, which makes a key difference to your final results
- Mexico is located in close proximity to the US and you can simply drive down or hop on a short flight to this exotic global destination
How to get insurance to pay for gastric bypass revision
If you have adequate health insurance coverage in the US, chances are that your gastric bypass revision procedure costs will be covered. However, you should still be prepared to pay the deductibles and co-pays from your own pocket. In absence of medical insurance, your best bet would be to undergo your Roux en y revision surgery in Mexico at a very affordable cost.
Many people may ask: “Does United Healthcare cover gastric bypass revision?” The good news is that in the US, many of the health plans from United Healthcare include gastric bypass revision insurance coverage. However, the company has stringent pre-approval criteria, such as Class 3 Obesity or Class 2 Obesity with specific co-morbidities. If you have limited coverage, be prepared to ask your insurance company whether they will cover your costs for RNY revision in Mexico.
You may want to know: “Does Cigna cover gastric bypass revision?” The answer is: Yes, most health policies with Cigna will provide gastric bypass revision insurance coverage. Remember that Cigna has now become a part of Great West Healthcare, so you should contact Great West to understand their pre-approval requirements and other terms and conditions for coverage. Cigna may also require you to first undergo a medically supervised program for weight management.
Medicaid may cover your gastric bypass revision surgery cost, subject to the condition that you have no medical issues that might prevent you from undergoing this surgery. Apart from completing other conditions, you will have to provide a letter from your PCP stating that a gastric bypass revision is medically necessary for you. You will also be required to clear a psychological exam and show proof that you tried but failed with standard treatments to reduce your weight.
Gastric bypass revision insurance coverage is available to approved beneficiaries under Medicare in the US. Whether the surgery is performed as an open procedure or laparoscopically, you can get the coverage as long as you meet the insurer’s requirements. One of the conditions for Medicare is that your revision procedure should only be performed at a surgical facility that has been certified either by the American Society of Bariatric Surgery or the American College of Surgeons.
Gastric Bypass Revision Surgery at Jet Medical Tourism®
Jet Medical Tourism® believes that your weight loss surgery procedure should be done right the first time itself. However, if for any reasons, you are required to undergo a gastric bypass revision, we have some of the most qualified and experienced bariatric surgeons on-board for this procedure. If you are looking to save up to 70% of your costs on gastric bypass revision surgery, you should talk to us today.
We will arrange your free virtual consultation with a surgeon and get you started on your safe and successful weight loss journey. Our dedicated team will stand by you and support you every step of the way from your initial consultation to your surgery day and beyond. Call us now to speak to one of our knowledgeable and compassionate representatives at Jet Medical Tourism®.