When bariatric surgery fails – Obesity Control Center

At OCC, we understand that revising a failing surgery is unique and must be approached on a customized basis. After thousands of patients that have undergone weight loss revision surgery, we can consider ourselves leading experts in the field.

Your revision surgery

We are innovators when it comes to revising and “saving” failed bariatric procedures. Hundreds of people come to us from around the world to fix their procedures and achieve their desired results.

What does revision surgery treat?

This surgery treats obesity, metabolic disease, sleep apnea, and diabetes. Bariatric surgery can also reduce high blood pressure, high cholesterol, and lower the risk of heart disease and heart failure.

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Revision Surgery on Bypass & Mini Bypass OCC Educational Program

How is it performed?

A vertical sleeve is created within the stomach through surgical stapling.

What is the discomfort after surgery?

Discomfort after our revision surgeries is minimal. You may experience some bloating after the procedure.

What are the side effects?

Bloating, heartburn, leakage (rare). Our revision techniques are performed to avoid these common side effects, with an advanced approach.

How do I prepare?

You will be guided through the pre-surgery diet and the supplements you need to take. Our nutritionists guide you every step of the way.

What is the downtime?

You will spend one night in the hospital followed by a three-month program of integrating back to normal, solid foods.

What is your follow-up program?

Five years of counseling and follow-up. You’re a member of the #OCCFamily for life.

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How to fix a failed bypass

It is a well-known fact that not everyone achieves long-lasting and successful weight loss with gastric bypass surgery (RYGB). It is worth noting that every person submitted to bariatric surgery responds differently. There is no simple explanation since there is a long list of variables for each of the following: patient, procedure, surgeon, technique, follow-up, post-operative “problems,” and more. 

It’s fair to say that most patients experience an initial good weight loss response to the procedure. Many have long-lasting results from the initial bypass surgery in maintaining a healthy weight. Successful weight loss is defined by keeping off over half of the excess weight at the time of operation. 

Why did my bypass fail to do what I hoped?

It is very worrisome for a gastric bypass patient when the weight starts to increase, or weight loss stops before achieving the expected goals. These issues can happen a few months or many years after the bypass. These are the most common reasons why patients start looking into options to improve their outcomes.

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How does bypass revision surgery work?

Before discussing revision options for RYGB, it is essential to note that the procedure works by combining two different mechanisms to achieve weight loss; one is malabsorption, and the other is restriction.

Surgeons generate malabsorption by rerouting the intestine. This rerouting results in the food not passing through the first section of the guy, leading to less absorption of calories. Also, rerouting modifies intestinal hormones to improve weight loss outcomes.

How much smaller is the stomach?

The restriction mechanism or capacity to eat less food volume is generated by the small gastric pouch (20% capacity compared to a normal stomach) and its new outlet. This restriction happens when the intestine is jointed (anastomosed) with the gastric pouch, also known as a stoma. When we study RYGB patients for insufficient or regained weight, we evaluate both mechanisms. Our doctors at the Obesity Control Center in Tijuana, Mexico perform revisions of one or both of these systems. Still, we must tailor to each individual after careful evaluation. To learn more about gastric bypass revision, visit ncbi.nlm.nih.gov

Talk with our US-Based Patient Coordinators today!

Call or email us here to start your journey to revising your procedure. Learn how you can finally get the life you deserve with help of the Obesity Control Center.

Three basic ways of revising a gastric bypass

  • Increasing restriction — most commonly used
  • Increasing malabsorption
  • Conversion to another procedure.

Revising a gastric bypass through increasing restriction

At OCC, we have extensive experience placing adjustable gastric bands (AGBs) in gastric bypass surgery patients, dating back to 2002. This is a safe revision option that yields excellent results. We routinely perform all gastric band adjustments under X-Ray, which has the advantage of generating adequate restriction and only requires two modifications.

No complications? It is possible at OCC.

Rare chronic complications related to AGB, such as slippage (the band slips down on the stomach) or erosion (bans migrates to the inside of the stomach), are much lower in patients who have had a gastric bypass. At OCC, we are proud to report no complications in our accumulated 18 years of experience with this procedure. Close follow-up is necessary to obtain the best results possible.

Surgical techniques: laparoscopy and endoscopy

Surgeons increase restriction through laparoscopic or endoscopic methods. Our surgeons can also utilize endoscopic methods that require no incision and are performed with an upper endoscopy. These include the StomaPhyx and Rose procedures. Both create folds around the stoma (gastric pouch outlet), substantially reducing its diameter while also reducing the size of the stomach pouch. 

Patients report less weight loss and durability with this type of technique. Laparoscopic procedures to increase restriction are limited, but more effective. The one that stands out is the adjustable gastric band system (AGB) on top of the gastric pouch. It can be regulated or adjusted to achieve the restriction needed to lessen food volume intake and obtain more weight loss.

Revising a gastric bypass through increasing malabsorption

We can increase malabsorption by diminishing the intestine’s length as food passes through for digestion and absorption. This procedure is associated with a higher surgical complication risk. Weight loss results with this technique are limited and not as predictable. Because malabsorption increases with this technique, the risk of malnourishment and chronic diarrhea increases.

Revising a gastric bypass through another procedure

Converting a Roux-en-Y gastric bypass (RYGB) to another procedure is not easy since it has to be reversed by establishing regular gastric continuity (the gastric pouch connects to the rest of the stomach).

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Gastric sleeve vs. gastric bypass

The Gastric Sleeve and Gastric Bypass are different procedures and work differently. They both have their pros and cons, and this question should be discussed with the surgeon who will perform the procedure. We really like the least invasive procedure that will achieve the best results. We always recommend a sleeve before the bypass. You can always move up to a bypass from a sleeve but not the other way around.

Revision weight-loss surgery in Tijuana, Mexico

At OCC, we understand that revising a failed surgery is unique and must be approached accordingly. This is why after thousands of patients that have undergone weight loss revision surgery, we can consider ourselves leading experts in the field. The Obesity Control Center holds the world's highest safety standards from the Joint Commission and is a Certified International Center for Excellence. These designations put OCC in the highest class of health and safety, exceeding many American hospitals.

Schedule your gastric bypass revision procedure today

Call or email us here to start your weight loss journey. Call one of our US-based coordinators and learn how you can get the life you’ve always wanted with the help of the Obesity Control Center in Mexico.

Innovators in revision surgeries

We are innovators when it comes to revising and “saving” failed bariatric procedures. Hundreds of people come to us from around the world to fix their procedures and we help them achieve their desired results.

Is it safe?

We deliver the highest rated, with safety standards, exceeding the protocols in most American hospitals. Certified by the Joint Commission, and a certified International Center for Excellence. Very few international hospitals achieve this status, and many American hospitals do not.

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Revising a failed gastric procedure

At the Obesity Control Center, we have your back. With over 26,000 procedures, we have streamlined not just the technique but the whole process of weight loss surgery. Failed surgeries can create health risks for those who expected dramatic weight loss as a result of their procedures. 

Achieve the result you wanted, at last.

Regardless of where patients had their surgeries performed, we can permanently restore them and bring relief through revision bariatric surgery. In fact, OCC has become a leader in providing affordable options that create life-long solutions. Our world-leading track record and innovations mean patients come from all over America and the world to have their gastric procedures revised. Plus with our 5-year program, you’re part of the #OCCFamily for life.

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What can cause the surgery to fail?

For a number of reasons, a weight loss procedure can fail to allow the patient to reach his or her goals. Whether it is gastric banding (Lap-Band/REALIZE bands), sleeve gastrectomy/gastric sleeves, vertical gastroplasty (stomach stapling), gastric plication, or gastric bypass surgery, a failed procedure is both disappointing and a major health issue.

  • Older techniques: There are multiple factors associated with failure. It can be the technique itself, either because it is outdated, or other more effective safer procedures have been developed.
  • Poorly executed surgery: The revision may address an error that is technical in nature, meaning that the surgery may have not been optimally executed. 
  • Stomach pouch stretching: It can also be the simple result of stretching, which would enlarge the gastric pouch, causing loss of restriction. In our opinion, it is a combination of several factors most of the time, which results in a failed surgery. To learn more about revision bariatric surgery, visit ncbi.nlm.nih.gov

Get help from the leaders in bariatric surgery.

One of our US-based coordinators can walk you through how you can get the life you’ve always wanted with the help of the Obesity Control Center in Tijuana, Mexico. Call or email us here to start fixing your failed procedure today!

Why choose Obesity Control Center?

Bariatric revision surgery is not just a technique. It is a scientific, evidence-based medical approach to correcting a failed weight loss procedure. The OCC Revision Surgery Program starts with an in-depth look at the patient’s history and any available medical records to understand the nature of the failure, as well as the best approach to resolve it.

Our comprehensive process

Once the patient is physically present, OCC has a wide selection of studies available to further evaluate the status of the surgery to be revised. This is only part of the OCC Revision Surgery Program, as our nutrition and physician team assess and affirm the patient’s understanding of the procedure and reignites the faith and hope associated with a new procedure. The goal is a safe, effective, and durable procedure. 

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What are my surgical options?

We offer a variety of revisions depending on your situation. OCC offers revisions for:

OCC compared to other weight-loss surgeons

Over 20 years of experience and more than 26,000 patients is what sets us apart at the Obesity Control Center in Mexico. We are the busiest standalone center of excellence in metabolic and bariatric surgery, and this gives us a unique advantage. Here are some unique features only found at OCC:

  • A quarter-century specialized in the weight loss surgery field. We were some of the first to perform bariatric surgical procedures.
  • Three Master Bariatric Surgeons caring for every patient. You’re always in the hands of a world-renowned and highly trained surgeon. We are the only international team of bariatric surgeons, offering globalized bariatric healthcare and the best of the best to our patients.
  • Fully accredited as an SRC Center of Excellence in Bariatric and Metabolic Surgery. We have also obtained the Golden Seal awarded by the Joint Commission International that signifies that we met the highest standards in patient safety and quality available globally.
  • Pioneers in the field, including several registered techniques, patented devices, and many “firsts” in the field like teenage obesity treatments, the IGS Improved Gastric Sleeve®, the Stomach Sparing Gastric Sleeve, the Double-Buttress Sewing Technique and more.
  • Faster recovery and better outcomes. Shorter times under anesthesia and a less-invasive abdominal wall preservation technique.
  • Unique patient pre-surgery education and preparation and 5 years follow-up program, an industry first!
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Bariatric surgery revision FAQ Pre-surgery

Who is an ideal candidate for gastric revision?

How do I prepare for gastric surgery?

How to enhance physical health before revision bypass surgery?

What supplements will I need?

What’s the price for a gastric revision?

What does OCC deliver in a bariatric revision surgery package?

Who is an ideal candidate for gastric revision?

A failed weight-loss procedure can be defined as one that has resulted in:

  • Less than 50% loss of the expected weight loss
  • Weight loss followed by partial, or total regain
  • An intolerance to normal/solid foods
  • Signs that the overall quality of life is diminishing
  • Additional health issues caused by the procedure

How do I prepare for gastric surgery?

Like in life, preparation is essential for a successful outcome, mentally, physically, and nutritionally. Additional requirements may be suggested depending on your specific case.

How to enhance physical health before revision bypass surgery?

Preoperative weight loss will detox your liver, making it lighter, and resulting in a quicker, safer weight loss procedure with less impact on your overall status. Even 5% of total body weight loss will result in a dramatic improvement in your ability to respond to surgical stress.

What supplements will I need?

Nourishment at a cellular level will require you to compensate for the deficiencies you have accumulated over the years and the deficiencies expected after weight loss surgery. Research has proven that the only way to replenish these deficiencies is through Bariatric Supplementation. This means that a Bariatric Multivitamin and a Bariatric Protein source prior to the Gastric Bypass will enormously increase your safety profile and a successful outcome. Mental preparation includes looking at the way we relate to food and being proactive about a healthier diet and lifestyle.

What’s the price for a gastric revision?

Depending on the type of gastric surgery requested, prices can vary from around $6,500 to $9,000 dollars. We suggest you look into testimonials online, talk to other patients, and don’t be misled by price. The savings by coming to OCC is around 50% of the cost in the US. Don’t risk it by looking for the lowest price. Your health and wellbeing are very valuable.

What does OCC deliver in a bariatric revision surgery package?

Included in the cost of your gastric surgery:

  • 1 night stay at our world-renowned hospital
  • 1 night stay at a local 5-star hotel
  • Luxury transportation to and from the San Diego International Airport
  • Team of three Board Certified surgeons, including two anesthesiologists
  • All operating room costs and surgical materials
  • All pre-op evaluations and follow-up care

Patient safety FAQ

Is revision surgery safe in Mexico?

What is your safety record for revision surgery?

Is gastric surgery painful?

What is the mortality rate for revision gastric surgery?

What is the risk of complications?

What are the side effects?

What are the side effects of anesthesia?

Can a revision be done in a single surgery?

Is revision surgery safe in Mexico?

At OCC, we have more than 26,000 patients that have traveled to our center with no major security incidents to report. We are at the heart of the commercial district, less than half a mile away from the international border to the U.S.A. Tijuana is now the second busiest medical destination for the traveling patient. At OCC, we are glad to be an essential part of this great reputation, as we have four full United States-based accreditations for health and safety in gastric revision surgery.

What is your safety record for revision surgery?

OCC’s complication rate is one of the lowest in the published literature.

Is gastric surgery painful?

Our process at OCC includes a gentle but short procedure that results in a quick recovery. The OCC difference includes specialized instruments and bladeless abdominal wall trocars. Localized abdominal wall blocking agents diminish the cascade of mediators that cause pain and inflammation. We use half the amount of gas pressure, where others use 20mm/hg, we use 10 to 12mm/hg. This results in less of the dreaded “gas pressure pains” associated with laparoscopic surgery. Our operating time is a fraction of the typical time reported in the literature. We’re in no hurry, we have simply streamlined the process. Less time under anesthesia means quicker recovery times.

What is the mortality rate for revision gastric surgery?

We can say very proudly that our mortality rate is zero percent. We value health and wellbeing and will never perform a procedure on someone who is either not well prepared medically or has a risk higher than acceptable.

What is the risk of complications?

Like any surgical procedure, complications can happen like leaks, bleeding, hernias, and chronic heartburn. Preparation is key to a successful outcome, and we will be holding your hand all the way. Our complication rate is one of the lowest published in the literature. In fact, our leak rate is 0%, and with the implementation of the new techniques designed at OCC, our patients are experiencing substantial and permanent weight loss without the undesirable symptom of heartburn.

What are the side effects?

Heartburn and reflux seem to be the predominant complaint after sleeve gastrectomy. At OCC, we have adjusted the technique to let the body heal properly and avoid this uncomfortable and common symptom months after the surgery is performed.

What are the side effects of anesthesia?

There are symptoms after having any type of surgery that are related to anesthesia (sleepiness, dizziness, nausea, etc.) and others directly associated with the gastric sleeve itself (cramping, abdominal tenderness, vomiting). Fortunately, these are kept to a minimum and medically treated early so most patients can be up on their feet in a couple of hours and discharged the morning after. Many actually are out shopping the day after surgery!

Can a revision be done in a single surgery?

Revision surgery depends on the original procedure and what the problem is. These patients undergo an initial evaluation through our program and are ultimately scheduled for revision surgery already knowing the possibilities of completing the surgery in a single step. Over 99% of these patients are done in a single step, in other words, one surgical event.

Post-surgery FAQ

Can you have a normal life after surgery?

How long until I feel normal?

How much can I eat?

How much weight should I expect to lose?

How much does the preparation for surgery matter?

What do I eat after gastric surgery?

I regained weight after my surgery – can it be fixed?

What is the most common revision technique?

How much can your stomach hold after gastric surgery?

How long does it take for your stomach to heal after gastric surgery?

Can you have a normal life after surgery?

Most patients require several months to adapt to the changes of the surgery. This is usually predictable so our nutritionist will always prescribe a nutritional regimen that is easy to follow and will allow you to gradually move up to the following stage. You will start with a liquid diet for a few days, then move on to liquids including the Bariatric Protein Meals. You can slowly start eating mushy foods and then, finally, a normal diet.

How long until I feel normal?

Daily activities and exercise should also progress at the same rate, but the surprising fact is that most patients recover much quicker than they thought; in fact, energy levels are usually higher than expected when the nutrition plan includes the Bariatric Multivitamin and Bariatric Protein Shakes recommended by our team of experts.

How much can I eat?

The only thing you can’t do after surgery is overeating without having severe discomfort, nausea, or even vomiting. Ideally, most patients will return to three normal meals a day and three snacks between meals.

How much weight should I expect to lose?

Gastric bypass is producing a substantial amount of weight loss in a relatively short period of time. A 65% EWL (excess weight loss) at 18 months is reported in general in the literature. For example, a patient that needs to lose 100 pounds (100 lbs. excess weight) will lose at least 65 pounds.

How much does the preparation for surgery matter?

Other factors that influence the total weight loss include how well prepared the patient is before surgery. Preparation not only includes mental and physical preparation, but it also includes nutritional preparation, and it seems to be one of the most important determining factors for success. Pre-operative preparations include supplementation and protein intake. This is why you will see that all patients at OCC undergo pre-surgery preparation and are followed for 5 years after the procedure. OCC Wellness is an online program that helps you achieve your goals.

What do I eat after gastric surgery?

It starts with liquids during the first few days gradually progressing to mushy food. Then semi-solid foods are eaten, moving on to full solids. All this happens during the first couple of months. The good news is massive weight loss occurs during this time and all the health indicators dramatically get better during this period.

I regained weight after my surgery – can it be fixed?

On average, most patients can tolerate around 30% of their pre-surgical intake after the stomach or pouch adjusts. This restriction is enough to maintain the weight loss through the years. Patients that expand their stomach to a point where they can eat more than 50% of their pre-surgical intake can be candidates for a quick stomach revision, which entails performing a running stitch to adjust the size of the plicated stomach over a calibration tube.

What is the most common revision technique?

In fact, this technique is so effective that patients who have a gastric sleeve with the same type of stomach stretching are candidates for the same technique. Simply sewing the staple line over a calibration tube can adjust the size of the sleeve. These procedures tend to be quick and effective with little downtime where patients regain the original restriction they had after the surgical procedure.

How much can your stomach hold after gastric surgery?

Patients will notice once they are past the liquid phase and eating full solids that the restriction level will result in around a third of the original meal volume. Eating a third of your typical meal will definitely induce weight loss and better overall health.

How long does it take for your stomach to heal after gastric surgery?

Recent studies show that the inner lining of the stomach can start healing in as little as 6 hours! It is important to follow all the guidelines that we teach our patients prior to surgery which results in an uneventful recovery and a good outcome.

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Schedule your gastric revision procedure today.

Call or email us here to start your weight loss journey. Call one of our US-based coordinators and learn how you can get the life you’ve always wanted with the help of the Obesity Control Center in Tijuana, MX.

References

  • J Dang, N Switzer, J Wu, et al. Gastric Band Removal in Revisional Bariatric Surgery, One-Step Versus Two-Step: a Systematic Review and Meta-analysis. Obesity Surgery (2016), 26:4
  • S Brethauer, S Kothari, R Sudan, et al. Systematic review on reoperative bariatric surgery American Society for Metabolic and Bariatric Surgery Revision Task Force. Surg Obes Relat Dis 10 (2014) 952–972.

Click here to see how OCC compares to other facilities in terms of surgical rates, infection rates, mortality rates, and more.

OCC’s epidemiologist is closely monitoring the COVID-19 status and is actively issuing updates as they are available. The Centers for Disease Control and the World Health Organization are the most trusted sources online.  While the CDC has announced new mask protocols for vaccinated individuals, there will be no changes for our office protocols for patients, guests, and staff members as the announcement does not apply to hospitals or medical facilities. Masks are still a requirement for all patients, guests and staff at our facility.

As we reinitiate weight loss surgery, we are constantly adapting and installing new and updated safety measures.

Weight loss surgery is medically necessary.

Bariatric Surgery and the clash of two pandemics.   

Major metabolic and bariatric surgery Societies and colleges globally are now calling for the safe resumption of bariatric and metabolic surgery before the COVID-19 pandemic is declared over. 

The sooner bariatric surgery can be safely performed, the quicker obesity, type 2 diabetes, and other diseases can be reduced or resolved as they are not only chronic they are also progressive.  Obesity is also linked to more than 40 diseases including type 2 diabetes, hypertension, heart disease, stroke, sleep apnea, osteoarthritis, and at least 13 different types of cancer.

A recent statement from the ASMBS says “Before COVID-19 began, it was clear that patients with obesity were ‘safer through surgery.’ In the era of COVID-19, ‘safer through surgery’ for patients with obesity may prove to be even more important than before.” Obesity and Metabolic syndrome have been identified as an independent risk factor for adverse outcomes including death among COVID-19 patients.

See here for full COVID-19 update. 

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