Revision and Conversion

Revision and conversion bariatric surgery refers to follow-up surgical procedures performed after an initial weight-loss surgery either to correct complications, enhance weight loss, or treat weight regain. These procedures are considered when the original surgery fails to produce the desired results, causes persistent side effects, or leads to mechanical issues such as pouch enlargement, staple line failure, or severe reflux. They are more complex than primary surgeries and require thorough evaluation.

Revision surgery involves modifying or correcting the existing procedure. For example, a patient who previously underwent sleeve gastrectomy and developed severe GERD or inadequate weight loss might have the sleeve converted to a Roux-en-Y gastric bypass. Similarly, a failed adjustable gastric band may be removed and revised to a sleeve or bypass. These procedures aim to restore or improve the original weight-loss benefits while addressing complications.

Conversion surgery, on the other hand, involves completely changing one type of bariatric surgery to another. This is common when the initial procedure becomes ineffective or harmful. For instance, patients with a gastric band may undergo conversion to sleeve gastrectomy or gastric bypass due to band slippage, erosion, or poor weight loss. Conversion may also be considered in cases of significant weight regain years after the initial surgery.

Because of scar tissue, altered anatomy, and higher risk of complications, revision and conversion surgeries carry greater surgical and postoperative risks compared to primary procedures. They require a highly skilled surgical team and careful preoperative planning. Patients undergoing these procedures must be committed to ongoing lifestyle changes and medical follow-up to achieve lasting results and avoid further complications.