Gastric Bypass Surgery Reversal

Gastric bypass surgery is a form of weight loss surgery in which the surgeon staples the patient's stomach to make it small and then reroutes the patient's small intestine so he does not absorb all the fat or calories from the food he eats. It's usually thought of as a permanent surgery but in fact the operation can be reversed if necessary.

Reasons for Reversal

Because the reversal process can require a longer operation than the original surgery and because it carries with it a number of risks, surgeons generally only perform the operation when patients experience severe long-term complications following their gastric bypass surgeries. Some reasons for reversal include severe nausea and vomiting that does not respond to other treatment, severe nutritional deficiencies, excessive weight loss and inability to regain to a healthy weight, severe dumping syndrome caused by numerous foods and severe reactive hypoglycemia.

Patients that don't like the dietary restrictions required after gastric bypass surgery or that experience minor complication may not be able to find a surgeon to perform a reversal operation even if they want one. Health insurance policies generally will not pay for a reversal operation unless it is medically necessary, as well.

Procedure

During gastric bypass reversal surgery the surgeon removes the staples, restoring the stomach to its former size. The surgeon then restores the small intestine to its normal configuration. Often the surgeon finds adhesions have formed due to the original surgery and these usually need to be removed during a reversal surgery. While gastric bypass surgery is often performed laparoscopically, reversal surgery often must be performed as an open procedure because it is a more extensive and complicated procedure.

Because the reversal surgery is more complicated than gastric bypass surgery itself, not all bariatric surgeons perform the procedure. Patients in need of a reversal may need to seek out a specialist and they may end up needing to travel some distance for the treatment they need.

Risks

Gastric bypass reversal surgery carries with it all the risks of any type of surgery, including respiratory problems related to anesthesia, blood clots and infections. Leaks can develop at the site of the intestinal repairs.

Patients often regain weight, sometimes a significant amount of weight, after gastric bypass reversal. Health problems like high blood pressure, diabetes and sleep apnea may return as well if the patient regains weight.

Patients and surgeons must carefully weigh the risks of gastric bypass reversal against the potential benefits and make a determination about what is in the patients' best interests.

Sources:

Bay Area Gastric Bypass. http://www.bayareagastricbypass.com/gastric-bypass-questions.htm#ob8. Can I Reverse My Gastric Bypass?

Annals of Surgery. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1356930/. Laparoscopic Roux-en-Y Gastric Bypass, But Not Rebanding, Should Be Proposed as a Rescue Procedure for Patients With Failed Laparoscopic Gastric Banding.