Regained weight after 20 yrs. Can I get my pouch reset?

First your surgeon would need to evaluate to understand your current situation with the bypass and figure out the best options to help you.  For example; can eat a similar volume of food compared to before the surgery,  then the focus would be on increasing restriction  to lessen  the food  quantity  intake (a gastric band is great at creating restriction in bypass patients), if the problem  is not related to  the amount  then the focus should be on nutrition, and if necessary conversion to another form of procedure.  A complete evaluation with a bariatric surgeon with experience in revision surgery would be the first step to figure out what the best option is.

Regaining weight after 20 years from bariatric surgery is not uncommon, and it’s important to approach the situation with a comprehensive understanding of your current health and habits. A "pouch reset" is a non-surgical approach that involves following a strict diet plan, similar to the post-surgery diet, to help you regain control of portion sizes and eating patterns. While it can be effective for some people, it’s not a guaranteed solution for significant weight regain.
After 20 years, other factors may also be at play, such as changes in your metabolism, eating behaviors, or the possibility that your stomach pouch has stretched over time. To determine the best course of action, I recommend a full evaluation, including imaging studies to assess your pouch size and function.
If the pouch reset doesn’t lead to the desired results, revisional bariatric surgery might be an option. This can involve resizing the pouch or converting to another procedure, depending on your individual needs and health status.

While it's not possible to "reset" the pouch created during gastric bypass surgery, there are options for individuals who have experienced weight regain or other complications many years after the procedure. Revisions to the original surgery may be considered in certain situations. However, it's important to note that such decisions should be made in consultation with a healthcare professional, ideally a bariatric surgeon, who can thoroughly evaluate your individual case.
Here are a few considerations:
Evaluation of the Pouch: If you are experiencing weight regain after 20 years of gastric bypass surgery, the first step is to undergo a thorough evaluation to understand the underlying causes. This may involve imaging studies, endoscopy, and other diagnostic tests to assess the condition of the pouch and the digestive tract.Revising the Original Surgery: In some cases, a revision surgery may be considered. This could involve modifying the size of the pouch, adjusting the length of the bypassed intestine, or converting to another bariatric procedure. However, these decisions are highly individualized and depend on the specific circumstances of each patient.Lifestyle and Dietary Changes: Before considering surgery, it's essential to evaluate and make necessary lifestyle and dietary changes. Adopting a healthy lifestyle, including regular physical activity and a balanced diet, is crucial for long-term success after bariatric surgery.Medical Management: Non-surgical interventions, such as medication or endoscopic procedures, may also be considered depending on the specific issues contributing to weight regain.It's crucial to consult with a healthcare professional experienced in bariatric surgery to discuss your concerns, undergo a comprehensive evaluation, and explore the most appropriate options for your situation. Keep in mind that revision surgeries carry risks and should be approached with careful consideration.
Weight regain after bariatric surgery can occur for various reasons, including changes in lifestyle, dietary habits, and metabolic factors. A comprehensive approach that addresses the underlying causes is important for achieving sustainable weight management.