The Roux-en-Y gastric bypass (RYGB), once the most popular procedure, is now the second most commonly performed bariatric procedure in the US behind the sleeve gastrectomy. While still considered to be the “gold standard” for surgical weight loss, it is not immune to failure, particularly in the super obese category (BMI≥50). This failure rate can be as high as 40 to 60 percent, depending on how failure is defined.
Introduction to Gastric Bypass Revision
Poor weight loss often leads patients to request a revision procedure. The most common indication for reoperation after RYGB is inadequate weight loss.
Am I a Candidate for Gastric Bypass Revision?
Careful nutritional and anatomic evaluation is helpful in understanding the causes of weight loss failure. In patients who present with failed RYGB, it is often useful to perform both upper endoscopy and upper gastrointestinal contrast studies, as they are complementary in the evaluation of anatomy and cause of weight gain after bariatric surgery. Endoscopy provides useful information about the pouch and stoma while upper GI detects esophageal and Roux limb abnormalities. Most patients who present to us with weight regain after RYGB have technically intact anatomy (i.e., no evidence of gastrogastric fistula) with a dilated pouch and/or dilated stoma.
Reasons for Gastric Bypass Revisional Surgery
Reasons to get gastric bypass revision surgery may include:
- Failure to lose enough weight
- Weight regain
- Medical complications
Laparoscopic Distal Roux-en-Y Gastric Bypass:
This minimally invasive procedure is designed to treat weight regain after gastric bypass surgery. This procedure can help you to lose more weight after weight regain by reducing your ability to absorb food and calories. This procedure converts a proximal (conventional) Roux-en-Y gastric bypass to a distal Roux-en-Y gastric bypass. It is usually only considered when the patient has a very low base metabolic rate and continues with poor weight loss results despite an augmented exercise program. At Texas Endosurgery Associates in Houston Texas, we specialize in the care of patients dealing with obesity including primary and revision bariatric surgery.
*Weight loss results can vary depending on the individual. There is no guarantee of specific results*.