Regained weight post Rou-y-gastric bypass. What are my surgical options for weight loss again?

Gastric bypass revision surgery is a surgery that is most frequently seen for weight gain, and there are ways to provide greater malabsorption, and thus obtain sustained weight loss.

Since you’ve already had gastric bypass, your surgical options for weight loss are more limited but still possible. You could consider a gastric bypass revision, which tightens the pouch or stoma if they’ve stretched over time. Another option is converting to a duodenal switch (DS), a more intensive procedure with higher weight loss but increased risk of nutritional deficiencies. Endoscopic procedures like an endoscopic stoma reduction (TORe) are less invasive options that shrink the pouch without surgery. There's also the lap band over bypass, where a band is placed around your existing pouch, but this is less common due to potential complications. Finally, a revisional sleeve gastrectomy may be possible, though it's rarely done post-bypass. You need to consult your surgeon for the best option in your considition.

Revisional gastric bypass surgery consists of analyzing the current situation of the anatomy of your gastric bypass, and analyzing whether the following can be done:
1. Reshape the gastric pouch. If the gastric pouch is large, it can be made smaller.
2. Remove candy cane. There is a part of intestine that is next to the gasteojejunal anstomosis, which remains as a blind intestinal loop, it is called candy cane, if it exists, it could be removed.
3. Distalization. The length of the pancreatic loop, the intestinal loop through which food will not pass, is increased, so there will be less length of intestine to absorb the nutrients from food.
Of course, with good follow-up and adherence to the recommendations, it is most likely that you will be successful with weight loss, and will not have complications such as malnutrition.