Possible to Have Second Gastric Bypass Surgery?

Question

I had gastric bypass surgery 30 years ago. I received no follow-up support. The surgery was reversed about 8 years later. I had lost a lot of weight and kept it off until after the reverse.I am quite obese again. What are the chances I could be approved for another bypass surgery? I believe the surgery is much improved and there is better support. My knees are failing because of my weight.

Ali Solmaz, MD · Answer

Having had a gastric bypass 30 years ago, later reversed, and now struggling again with severe obesity and related health problems, it is understandable that you are considering another bariatric procedure. The good news is that bariatric surgery has advanced greatly in the past three decades, both in terms of technique and long-term support.
Yes, it is possible to undergo a second bariatric surgery, but it requires careful evaluation. The fact that your bypass was reversed means your anatomy is different from someone who has never had surgery. Scar tissue and prior operations make the surgery more complex, and the risks are somewhat higher. For this reason, it is essential to work with an experienced, high-volume bariatric surgeon who is familiar with revisional procedures.
Approval depends on your current health, Body Mass Index, and related conditions&mdash;such as your knee problems, which clearly demonstrate that your weight is significantly affecting your quality of life. Most patients who meet current medical criteria can be considered, but insurance approval may require additional documentation and a thorough review of your medical and surgical history.
In summary, while it is more complex, a second bariatric surgery can be possible and safe in the right hands. I recommend consulting with a board-certified bariatric surgeon who specializes in revision cases, as they will be able to assess your anatomy, discuss your options, and design a plan that fits your needs today.

David Oliak, MD · Answer

Revision surgery is almost always more difficult (and carries a higher risk) because scarring occurs after every operation. However, this does not mean you are not a candidate for a repeat gastric bypass. You would need to consult with a bariatric surgeon experienced in revision operations. He/She would likely want to review your old records to understand exactly what procedures were done and discuss what procedures (if any) you may be a candidate for.

Shawn Garber, MD, FACS, FASMBS · Answer

The risk of another gastric bypass with that history is extremely high.  I would consider a Lap-Band instead which would have much lower risk,

	Shawn Garber, MD FACS

	The New york Bariatric Group

Ricardo M. Bonnor, MD, FACS · Answer

First of all revision surgery for gastric bypass has a higher potential complication rate than primary gastric bypass (gastric bypass for the first time). Revision is a catch all word that means change so a patient can have revision from lap band to gastic bypass, revision from sleeve gastrectomy to gastric bypass, revision VBG to gastric bypass etc..
Once a bariatric procedure is revised to a gastric bypass, it is very rare to have a second surgical revision although a patient may be candidate for endoscopic procedures that are now currently available to decrease the size of the pouch. These procedures are at their early stage and we don t have long term data on efficay and safety at this point in time. Your may consult with your local bariatric surgeon. I hope this helps.

Mark Pleatman, MD (retired) · Answer

If I understand your question correctly, your gastric bypass has been reversed, and you are now again morbidly obese.  The short answer is that you could still have another weight loss operation.  The long answer is that we need to get an accurate history of what was actually done before, and why it had to be reversed.  You may not have actually had a gastric bypass.  You may have had a jejuno-ileal bypass, or some other type of malabsorptive procedure.  The safest way to find out, other than doing exploratory surgery, would be to get your old operative reports.  It may take a bit of detective work, but most hospitals store these records for a very long time.

	As to whether or not your insurance company will agree to pay for another operation, that depends on your specific policy.  Some companies will cover it, and others won't.  But the bottom line is that you can have another weight loss operation.

Possible to Have Second Gastric Bypass Surgery?

Answers (5)

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