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Bariatric revision procedure in Virginia, Maryland, Washington

What is Bariatric Revision?

Bariatric revision refers to a non-surgical procedure performed endoscopically (through the mouth) to treat weight regain in patients who previously had a gastric bypass or a sleeve gastrectomy. 

What is Gastric Bypass Revision?

Gastric bypass revision, or Trans-oral Outlet Reduction (TORe), is a non-surgical outpatient procedure. Sutures are used to tighten the gastrojejunal anastomosis and restore it to its original size in patients experiencing weight regain after gastric bypass.

Learn more about gastric bypass revision.

Gastric Sleeve Revision

What is Gastric Sleeve Revision?

Gastric sleeve revision, or sleeve gastrectomy revision, is a non-surgical outpatient procedure. Sutures are used to tighten the dilated gastric sleeve and restore it to its original size in patients experiencing weight regain after sleeve gastrectomy surgery.

Learn more about gastric sleeve revision.

Who is bariatric revision for?

Bariatric revision is suited for patients who previously underwent gastric bypass surgery or sleeve gastrectomy, but who are now experiencing weight regain.


How does bariatric revision work?

Bariatric revision is an outpatient endoscopic procedure. It is not a surgery. There are no incisions or scars. The endoscopist advances an endoscope (a tube with a camera and a light on its tip) through the mouth to the gastric pouch or the gastric sleeve. The scope is equipped with a suturing device that allows us to suture the gastrojejunal anastomosis (gastric bypass) or the gastric sleeve (sleeve gastrectomy) to restore it to its original size. This is performed under sedation. It does not require admission to the hospital. After the procedure, the patient will start feeling full after smaller meals again, which helps with weight loss.


How long does an endoscopic bariatric revision procedure take?

Endoscopic bariatric revision is a quick outpatient procedure. The procedure itself takes less than half an hour. You will need to present to the outpatient surgery center an hour before your procedure time. After your bariatric revision, you will be watched in the recovery area for 1-2 hours. Then you are discharged home.


What is the recovery after bariatric revision?

After your endoscopic bariatric revision, you will recover in the surgery center for an hour or two, then you will go home. You will need someone to drive you home, as you are not allowed to drive for 24 hours after receiving anesthesia. The first day or two after your bariatric revision, you may experience some nausea or pain in your upper abdomen. You will be provided with medications to treat these symptoms if they occur. We usually recommend that you take 2-3 days off work after undergoing endoscopic bariatric revision. After that, you can go back to work and to your usual routine. We may recommend against heavy lifting and some strenuous activities in the first-week post-revision.


What is the diet like after endoscopic bariatric revision?

You will progressively advance your diet after your revision, just like you did after your initial bariatric surgery. You will be on a clear liquid diet for two days then gradually advance to a full liquid diet for a couple of weeks then to a soft diet for a couple of weeks then you can go back to a regular consistency diet.


What are the benefits of endoscopic bariatric revision?

Compared to surgical bariatric revision, endoscopic bariatric revision carries many advantages. Most patients do not want to undergo another surgery. Endoscopic revision is ideal for these patients as it is performed through the mouth without surgery, incisions, or scars. The endoscopic bariatric revision also carries much less risk than the surgical bariatric revision. It involves suturing only without cutting the stomach or the bowel. The procedure is performed as an outpatient and does not require hospital admission, and the recovery is very fast. The endoscopic revision restores the potential for weight loss from the initial bariatric surgery.

What evaluation is required before the bariatric revision procedure?

We may recommend that you undergo an upper endoscopy (EGD) to determine whether you would benefit from a bariatric revision. We would need to evaluate your gastric pouch and outlet (in gastric bypass patients) or your sleeve (in sleeve gastrectomy patients). If dilation has occurred with time, it can be corrected endoscopically with suturing during an endoscopic bariatric revision. We may also require some basic blood tests before you undergo anesthesia. Additional tests or clearance may be required if you have certain medical conditions.

What are the risks of the bariatric revision procedure? 

Endoscopic bariatric revision is a very safe procedure. After the procedure, you may experience some upper abdominal pain and nausea. These are usually controlled with medications and they resolved in 1-2 days. More serious possible complications such as bleeding, leak, or infection are extremely rare. 

How do you keep the weight off after bariatric revision?

After your revision, we work with you to adopt a healthy diet and an active and healthy lifestyle. Long-term weight loss results require work, dedication, and commitment. Our team is there for you to help you through the process and to provide you with the tools you need for success. Our comprehensive after-care program includes medical and nutrition support and monitoring. Our bariatric dietitians meet with you every month and they are always available to answer any questions you may have.

Get your weight loss journey back on track with bariatric revision!

Gaining weight back after having lost it with much effort and hard work after bariatric surgery can be disheartening and very frustrating. If you experienced weight regain after your bariatric surgery, call us at: (301) 288-1319 to schedule a consultation.