Weight-loss Revision Surgery Perth

What is Revision Surgery?

Revision weight loss surgery is a follow-up procedure performed on patients who have experienced suboptimal results from previous surgery. Through revision surgery, Dr Siva aims to enhance the previous procedure’s effectiveness by resolving complications or modifying the surgical technique to achieve improved weight loss results.

The decision to undergo revision weight loss surgery is a significant one, and it requires careful consideration. Siva will assess your individual circumstances and work with you to determine if revision weight loss surgery is the best course of action for you.

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Reasons Why Revision Surgery is Performed

Inadequate weight loss or weight regain

Failing to lose your desired amount of weight after bariatric surgery is the most common reason to undertake revision surgery. This can happen due to: 

  • Not adopting recommended healthy lifestyle and eating habits post-surgery. 
  • The initial bariatric surgery undergone failed to address your metabolic needs. 
  • The physical modifications made during the initial procedure may not have been preserved, leading to complications such as Lap Band slipping. 

Unresolved health problems: diabetes/hypertension

Co-morbid health problems are health conditions that often occur alongside obesity, such as diabetes, hypertension, and sleep apnea. Bariatric surgery can be an effective treatment for these health problems, but in some cases, the initial surgery may not provide enough improvement. If your health problems remain unresolved after the initial surgery, it can be deemed a failed obesity surgery and therefore eligible for a revised procedure. 

Complications following initial surgery

Complications following weight loss surgery can also necessitate revision surgery. These complications can include vitamin deficiencies, anemia, malnutrition, and ulcers. The course of action for a revision weight loss procedure will depend on the type of complication you’re experiencing. Dr Siva will carefully evaluate each case to determine the best approach. 

Intolerance of original surgery

Severe reflux after a gastric sleeve surgery or severe dumping syndrome after a gastric bypass may result in revision weight loss surgery using a different procedure. 

Excess weight loss

Although this is rare, some patients can become malnourished with too much weight loss and need the original operation reversed. 

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Dr Siva's Approach

Dr Siva, a renowned weight loss surgeon at Perth Obesity Solutions, conducts a thorough evaluation of each patient’s medical history, surgical history, and lifestyle choices to determine the underlying cause of their failed bariatric surgery. This comprehensive approach enables Dr Siva to develop a tailored treatment plan for each patient, addressing the specific issues that led to their initial weight loss surgery’s failure. By doing so, Dr Siva can help patients achieve their desired weight loss results and improve their overall health and well-being.

How to Revise a Gastric Bypass 


Revision surgery for gastric bypass is challenging, though there are a few options depending on your individual needs and circumstances.

The first step is to run radiological scans and an endoscopy to view the size of the stomach pouch and anastomosis.

In a case where the pouch has stretched, Dr Siva can resize the pouch whilst adding a minimiser ring to prevent further stretching. In the case of a stretched anastomosis, Dr Siva can also re-tighten and resize the anastomosis back to its post-surgery size.

In a case where both the pouch and anastomosis are normal, Dr Siva can reduce the length of the channel between the gastric pouch and colon. This, however, can cause significant long-term side effects such as diarrhoea and flatulence. In cases where side effects are intolerable, this revision procedure can be undone.

How to Revise a Gastric Sleeve 

There are several options available for gastric sleeve revision surgery, and the choice of procedure depends on the reason for revision. Before deciding on a course of action, a comprehensive evaluation of your medical history, surgical history, and lifestyle choices is necessary.

The first step in determining the appropriate revision procedure is to conduct an endoscopy to evaluate the state of the gastric sleeve and determine the extent of reflux symptoms. Based on this information, Dr. Siva will consider which approach will be most effective.

Re-tighten the Gastric Sleeve

If the gastric sleeve has stretched or was not originally sized correctly, re-sleeve surgery may be the best option. This procedure involves excising the stretched part of the sleeve and tightening it back down. Re-sleeve surgery can help with weight loss by reducing the amount of food that can be consumed, but it does not address reflux symptoms.

Roux-en-Y Gastric Bypass Surgery

Roux-en-Y gastric bypass surgery is another option for patients experiencing reflux symptoms. This procedure involves rerouting the small intestine to create a small pouch that limits food intake and reduces the absorption of calories. While it is effective in controlling reflux symptoms, roux-en-Y gastric bypass surgery does not provide significant additional weight loss compared to the gastric sleeve.

How to Revise a Gastric Band

While gastric bands are designed to be permanent, some individuals may experience complications. These include degradation of the silicone, leakage of the saline, and loosening of the band. As a result, the band may lose its effectiveness, leading to the need for a revision.

At Perth Obesity Solutions, we provide several options for gastric band revision, including:

Gastric Sleeve Surgery

This option provides the same restriction as the band without the risk of food becoming lodged in the stomach or vomiting. Additionally, there is no malabsorption, so vitamin deficiency is less of a concern.

Roux-en-Y Gastric Bypass Surgery

This option is an excellent choice for controlling reflux and achieving weight loss.

Another Gastric Band

While some individuals prefer this option, we discourage it as we believe we can offer better alternatives to achieve your weight loss goals. If you opt for another band, please note that the same issues may arise. Additionally, the new band carries the same risks as the initial band, such as slipping or eroding into the stomach.

Risks of Revision Surgery

Careful consideration should be given before opting for revision weight loss surgery. Each procedure has its own individual risks, and it’s important to weigh up the potential benefits and risks before proceeding with revision surgery. 

Risks involved with a second bariatric surgery can include: 

  • Greater likelihood of blood loss 
  • Elevated risk of leaks and infection 
  • Increased surgery time 

Preparing for Revision or Failed Weight Loss Surgery

It is crucial to avoid any consumption of food or liquids starting from midnight on the evening before your surgery. There will be other preoperative requirements depending on the revision surgery procedure you are undergoing. To have a comprehensive understanding of these pre-operative obligations, it is important to have a detailed discussion with Dr. Siva.

What to Expect After Revision for Failed Weight Loss Surgery

Postoperative instructions will be tailored according to the nature of the revision surgery. Generally, patients will require some time off from work for several weeks to rest and recover post-surgery. It is common for patients to adhere to a liquid and pureed food diet following revision surgery. Dr. Siva will provide personalised guidance regarding the specifics of postoperative care for each patient.

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