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Gastric Bypass Revision NYC

Some patients who have undergone gastric bypass either have not had the expected result, or over time, have once again begun gaining excess weight.

Gastric bypass revision surgery may be necessary if the stomach pouch has enlarged, or if the original surgery did not produce the dramatic weight loss expected from gastric bypass surgery.

Patient Journey

From beginning to end, the journey for a patient undergoing bariatric care is full of changes. It will require persistence and discipline, but at the end it is all worth it. Feel free to learn more about the patient journey.

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What is the Lap Band?

Popularly known as the LAP-BAND®, a gastric band is a hollow band made of special material is placed around the stomach near its upper end, creating a small pouch and a narrow passage into the larger remainder of the stomach. The band is then inflated with a salt solution. Following the initial surgery, the band itself can be tightened or loosened over time to change the size of the passage by increasing or decreasing the amount of salt solution.

In certain patients, we can do this with a single incisions in your belly button, so a scar is barely noticeable.

How does the Lap-Band surgery work?
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How does the Lap-Band surgery work?

In the surgical procedure, the band is placed around the upper part of the stomach, creating a small pouch that can hold only a small amount of food. The narrowed opening between the stomach pouch and the rest of the stomach controls how quickly food passes from the pouch to the lower part of the stomach. The system helps the patient eat less by limiting the amount of food that can be eaten at one time and increasing the time it takes for food to be digested.

Depending on the patient’s needs, after the device is implanted via the initial surgery the narrowed opening between the pouch and the lower part of the stomach can be adjusted in size by inflating or deflating the hollow band. Inflating the band makes the opening smaller, causing food to pass more slowly. Deflating the band makes it wider, and causes food to pass more quickly. This adjustment is made by adding or removing fluid inside the hollow band. The doctor does this by injecting or removing the fluid through a small button-like part called the access port. This access port is placed under the skin in a muscle in the chest wall. The port is connected to the band by the tubing. Learn about the adjustments of the band post-op below.

Advantages of Lap-Band Surgery?
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Advantages of Lap-Band Surgery?

Gastric banding is most simple of the bariatric surgery options, and leads to the smallest number of serious complications. LAP-BAND patients often return to work in just a week or two. Another advantage of this weight loss treatment is that the band is adjustable. This means that the surgeon can change the level of fluid in your band at a quick office visit. Adding fluid makes the band tighter, and removing fluid makes the band looser. Each patient is different, so as time goes on you will work with our team and can call the office any time your band feels too loose or too full.

Another advantage of the band is that it is reversible. Although the band is meant to stay in place permanently, if there are side effects or other reasons to remove it, this is an option. No cutting or stapling is done, and the anatomy of the body is not changed at all when the gastric band is put in place. The LAP-BAND also does not have a malabsorbtion risk, like other procedures. When part of the stomach is removed or the intestines are rerouted, patients’ bodies absorb fewer nutrients which can lead to negative health consequences, especially if they do not follow their vitamin and supplement routine. Because the LAP-BAND has no risk of malabsorbtion, there would be no extra vitamin deficiencies to worry about.

Disadvantages of Lap-Band?
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Disadvantages of Lap-Band?

Most patients experienced at least one side effect. Common side effects include nausea and vomiting, heartburn, abdominal pain, and slippage of the band. The most serious side effects required either another operation or hospitalization.

Because of the LAP-BAND design, it can be tempting to ‘cheat’ on your diet. Foods like chocolate or ice cream are easy to eat with the band, so it is important that patients commit to the eating changes that need to go with the surgery in order for it to be successful. It is also possible for food to get stuck, if you take bites that are too big or do not chew your food very carefully. This can be uncomfortable and potentially dangerous. Patients must be mindful of eating carefully with the band.

Most patients experience at least one side effect when they have a LAP-BAND. Common side effects include nausea and vomiting, heartburn, and abdominal pain. Some side effects are managed in follow up visits, but the most serious side effects require either another operation or hospitalization. There are risks to the gastric band, just like there are with any surgical procedure. These risks include prolapse, pouch dilatation, band erosion, and infection of the band, or port leak.

WHEN SHOULD IT NOT BE USED?

An adjustable band procedure should not be used for people who are poor candidates for weight loss surgery, have certain stomach or intestinal disorders, have an infection, have to take aspirin frequently, or are addicted to alcohol or drugs. It should not be used on patients who are not able or willing to follow the rules for eating and exercise that are recommended by the doctor after surgery.

Is Lap Band Surgery Right for Me?
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Is Lap Band Surgery Right for Me?

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  1. If your BMI is 40 or higher, you qualify for the Lap Band
  2. If your BMI is between 30 and 40 and you have a medical condition due to obesity, you qualify for the Lap Band
How to get started?
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How to get started?

  • The Insurance experts at the New York bariatric Group will verify your insurance benefits for you free of charge.
  • The first step is to call or contact us to make an appointment with one of the experienced surgeons at the New York Bariatric Group.
  • As a candidate for bariatric surgery, you can expect to undergo a series of consultations and evaluations. A detailed comprehensive program has been developed to ensure your long-term health and safety pre- and post-surgery.
  • Dr. Garber explains how you can initiate the process to become a new healthier you.
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  • You will receive extensive patient education from our psychologist who will perform a psychological evaluation that is required by the hospital and most insurance providers.
  • Meet with our registered dietitian to discuss healthy lifestyle changes pre- and post- weight loss surgery.
  • Participate in studies to determine your pulmonary, gastrointestinal and cardiovascular health. You can usually complete this entire work-up in one day in our office.
  • After the work-up is completed you will meet with your surgeon for a second visit to be scheduled for surgery. Our insurance experts will then obtain approval from your insurance company.
  • You will be scheduled for preadmission testing at the hospital. During this testing you will meet our bariatric coordinator who will give you a complete educational class on how to prepare for surgery? What is going to happen when you arrive at the hospital on your surgery day, as well as what to expect when you go home form the hospital.
Day of Surgery and Recovery
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Day of Surgery and Recovery

It is important to remember that The New York Bariatric Group and its affiliate Bariatric Center has been recognized as a “MBSAQIP and its Accredited Center-Comprehensive”. This designation provides the public with the assurance that our practice provides complete care for patients before, during and after bariatric surgery, and we have a proven track record verified by an independent review organization.

Based on this designation, we have proven that your hospital stay, will provide all that is necessary for a fast and pleasant recovery. From our full time bariatric nurse coordinator to specialized equipment that is needed to fulfill the needs of patients post-bariatric surgery, including bariatric chairs, beds, gowns and other specialized equipment. At the end of your hospital stay, you will find that our program is designed solely for the purpose of the bariatric patient.

The surgery usually takes only 25 – 35 minutes and is performed under general anesthesia. You will usually spend one night in the hospital or sometimes can go home the same day. Once you are tolerating pureed food you will be discharged home.

Recovery Period

The recovery period after Lap-Band surgery is usually just 3 -5 days until you can return to work. With the virtually scarless (SILS) single incision technique you can soemtimes return to work sooner.

Lifestyle Changes after Lap-Band
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Lifestyle Changes after Lap-Band

Adjusting to your post bariatric surgery diet and lifestyle is one of the most important keys to your long-term success. Develop healthy daily habits based on eating in moderation that match your new body instead of failed eating patterns that can ultimately lead to poor health, fatigue, depression and attempts at binge eating. Making a commitment to lifestyle change will bring fast & substantial weight loss. Let us show you how.

Depending on the patient’s needs, after the device is implanted via the initial surgery the narrowed opening between the pouch and the lower part of the stomach can be adjusted in size by inflating or deflating the hollow band. Inflating the band makes the opening smaller, causing food to pass more slowly. Deflating the band makes it wider, and causes food to pass more quickly. This adjustment is made by adding or removing fluid inside the hollow band. The doctor does this by injecting or removing the fluid through a small button-like part called the access port. This access port is placed under the skin in a muscle in the chest wall. The port is connected to the band by the tubing. Learn about the adjustments of the band post-op below.

Post Surgery Diet
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Post Surgery Diet

Post bariatric surgery diet guidelines are fully discussed with patients during their comprehensive nutritional evaluation prior to surgery.  Patients follow a Stage I diet for the first 4-6 week after surgery.  This includes all foods that are soft, mushy and/or pureed consistencies.  Examples for pureed foods are anything blended and smooth such as baby foods, fruitless yogurt, cottage cheese and hummus.  Soft/mushy foods include chopped up ground meats such as turkey, veal, chicken or pork, soft, white, flaky fish that is baked, broiled or grilled, scrambled eggs and egg whites.  Solid foods of all kinds should be completely avoided until weeks 4-6 or when the surgeon allows it.

This practice stresses the importance of good hydration, using non carbonated, decaffeinated, sugar free beverages.  We always promote good quality proteins to be consumed from day one after bariatric surgery.  High sugar and high fat foods are limited and very specific guidelines are provided to help equip patients with a clear-cut way to determine which foods are healthy for them to eat.  Fruits, vegetables, and high fiber foods are reintroduced after the first 3 months.  All patients get full details on dietary progression from our experienced nutritionists at their follow up visits.

The New York Bariatric Group is fully dedicated to promoting high standards for nutritional health. That doesn’t mean that patients should not enjoy eating. The New York Bariatric Group weight loss program has been designed to help patients lose weight rapidly, but provide you with resources to help enjoy your new lifestyle by keeping the flavor and fun in eating. Each patient is given the option to enroll in our Store. We brought together great tasting meals and supplements for breakfast, lunch, dinner and even snacks which can be ordered on our website.

Success Stories
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Success Stories

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Success Stories
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Success Stories

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Weight gain after gastric bypass surgery

If you have had gastric bypass surgery in the past, and are now regaining the lost weight, it may be associated with changes in your stomach and intestine that make it possible to consume more food – and calories. A revision surgery may be necessary.

At New York Bariatric Group, our team of professionals is often called upon to perform gastric bypass revision surgery to assist those who are not experiencing the dramatic weight loss expected from gastric bypass surgery, or over time, are regaining the weight they lost after the surgery.


What is gastric bypass revision surgery?

Some patients who have had gastric bypass surgery will slowly begin to regain weight. This may be the result of changes in how you eat, exercise, or as a result of pregnancy or other life change. In other cases, the weight gain is the result of changes in anatomy – the stomach pouch has enlarged over time.

Gastric bypass revision surgery restores a smaller stomach size. In most cases, this surgery is performed laparoscopically.

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Gained weight after gastric bypass surgery? We can help.

At New York Bariatric Group, we help those who are struggling with weight gain after undergoing gastric bypass surgery, or those who failed to lose weight as expected.

The first step in this procedure is a full health evaluation to determine the underlying cause of the weight gain or lack of results. The problem could be related to any of the following:

  • Dietary changes
  • Lack of exercise
  • Stomach pouch enlargement
  • Medical complications

If your increase in weight is the result of dietary changes or lack of exercise, these issues can be discussed in your medical evaluation at New York Bariatric Group. However, once the stomach pouch has enlarged, revision surgery may be the most effective option.


Inadequate weight loss after gastric bypass surgery

A gastric bypass surgery may have resulted in complications preventing the expected weight loss. The size of the altered stomach pouch may have been left too large in the initial surgery. A range of other medical issues that could inhibit weight loss could be associated with diabetes medications that trigger the production of fat and cholesterol.

A full evaluation of your condition will reveal if you are a candidate for gastric bypass revision in NYC. Studies reveal that about 15 to 35 percent of patients who have undergone gastric bypass surgery start to regain weight over time. If this happened to you, revision surgery may be the answer that will get your health and body back on track.

Statistics on bariatric surgery revisions in the USA

The American Society for Metabolic and Bariatric Surgery reports on the numbers of revision surgeries performed yearly. In the most recently reported year, 14.14 percent of the bariatric surgeries performed in America were revisions.

How is gastric bypass revision surgery done?

At New York Bariatric Group, gastric bypass revision surgery can be performed endoscopically. A minimally invasive procedure called “laparoscopic distal Roux-en-Y” surgery has been designed to treat patients who are experiencing weight gain after undergoing gastric bypass surgery.

This procedure involves altering the connections in the digestive tract so that less calorie absorption occurs, and significant weight loss is achieved.


What are the options for gastric bypass revision surgery?

The first step in determining what should be done in your case is a full evaluation of your health, and the specific conditions that have led to the failure to lose weight, or weight gain after gastric bypass surgery.

Once this medical evaluation has been performed, we can determine which procedure will be appropriate for you. As our team of bariatric surgeons has more experience with weight loss surgery than any practice in the state, you can be confident in our skills and your treatment.

Roux-en-Y

Distal Roux-en-Y surgery can be performed if you have failed to achieve long term weight loss from a primary gastric bypass surgery.

In this procedure, the connections between stomach and intestines are altered so that the food passes into the large intestine. Less intestinal tract will be available to process food and calories, and fat absorption is more thoroughly managed so that significant weight loss can be achieved.

Duodenal switch

In this revision surgery, the duodenum, which is the first section of the small intestine, is surgically divided just after the outlet of the stomach structure. The “distal,” or last portion of the small intestine is then connected to the newly created stomach.

When you consume food, it will pass through a newly-created tubular stomach pouch, and then emptied into the last segment of the small intestine. In this procedure, about three-fourths of the small intestine will be bypassed, leading to significant weight gain.

Laparoscopy

LABG, or “laparoscopically adjustable gastric banding,” involves placing an inflatable band around the top portion of the stomach, which is then inflated, compressing the stomach.

It separates the stomach into two sections, with a smaller upper stomach pouch, limiting the amount of food that can be comfortably consumed. The band is adjustable and can be altered to restrict more food if needed. The band may require adjustments over time, which are performed laparoscopically.

Another option is surgically tightening the connection between the stomach and the intestines so it restricts the quantity of food you can comfortably consume to correct stomach enlargement.


Why Choose Dr. Garber and NYBG for gastric bypass revision?

At NYBG, Dr. Garber and the bariatric surgeon team are the leaders in bariatric surgical techniques in New York, including for gastric bypass revisions.

Our group was formed by four of the leading weight loss surgeons in the USA. We take our responsibility to our patients’ health very seriously, and to date, we have assisted thousands of people struggling with obesity to lead happier, healthier lives.

We offer the most advanced techniques for weight loss surgery, including the non-surgical weight loss balloon, laparoscopic adjustable banding, sleeve gastrectomy, gastric bypass, and revision surgeries for failed or failing bariatric surgeries.


Am I a candidate for gastric bypass revision surgery?

Candidates for gastric bypass revision surgery include:

  • Patients who see increased weight gain in the years following gastric bypass.
  • Patients who failed to lose the expected quantity of weight after gastric bypass surgery.
  • Patients who require closing a gastro-gastric fistula after bariatric surgery.

As with any surgical procedure, a full medical evaluation must be performed. At New York Bariatric Group, we adhere to very strict patient health and safety protocols and can evaluate your condition and advise you about the type of revision surgery appropriate to you.


Benefits of gastric bypass revision surgery

The decision to undergo gastric bypass surgery is important and often stressful. If you have undergone the procedure, recovered from the surgery and then discover that the surgical procedure was not effective, it can be very depressing. If you did achieve dramatic weight loss, and then slowly began to regain the weight you lost, action should be taken immediately, for your own health.

The benefits of gastric bypass revision surgery include:

  • The ability to maintain a healthy weight
  • The expected weight loss from the initial surgery is now achieved
  • Any problems, such as enlarged stomach pouch or dilated section between stomach and intestine corrected.
  • Complications such as an ulcer, hernia, or other complication can be successfully resolved

Recovery

Your recovery time will be based upon the type of revision surgery that was performed but is typically about two to three weeks. With laparoscopic surgery, the recovery time is about two weeks for most patients. Results with the Roux-en-Y technique has proven to be excellent.


Is it covered by insurance?

To determine whether your health insurance will cover the cost of revision surgery, we offer the assistance of our friendly, helpful staff.

Your health insurance company will want to know why the initial surgery failed – was it based upon a failed surgery, or a result of the patient failing to maintain a healthy weight due to excess food intake that caused the stomach pouch to stretch.

At NYBG, we will perform a full evaluation and assist with anything else that your insurance company might require.


What are the results like?

The results of our gastric bypass revision surgery are excellent. If you had gastric bypass surgery in the past and failed to lose the expected amount of weight, or are regaining the weight you lost, we invite you to visit us at New York Bariatric Group to get answers.

The results of a revision surgery should lead to total success in your weight loss journey – but these procedures must be performed with the latest advances in bariatric surgery. At NYBG, we stay at the forefront in the latest developments in bariatric surgery and are recognized leaders in the field.

Getting Started

Our team is happy to speak with you and help you understand any of the treatments we offer, or answer any questions you have. Please call and speak with us at 800-633-8446, or read more about the surgical and non-surgical options we offer here.

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What our patients are saying

“The staff and doctors at the New York Bariatric Group are amazing! They are always patient, helpful, and very understanding and pro-active with questions, problems, etc. After Lap Band surgery I feel fantastic. For the last 6 years I have not had to worry if my clothes would fit. I have been able to maintain my weight loss, and have so much more energy.”

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"Dr. Holover has a great personality, I love him, I consider him a good friend, and I recommend him to everyone. He and his staff are amazing. I thought my recovery would be worse, but it wasn’t. It was great. After a couple of days I was back on my feet and going, with three boys you don’t have time to be down. Now, my kids have to keep up with me!"

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"My results are incredible; I can go to any store and find clothes that fit, I don’t have to go to the big and tall store anymore. My family and friends say I look great, but more so are so happy about my health. Definitely go for it, it is well worth it."

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"My recovery was very easy, I started moving around pretty quick because the nurses had me up and about. Dr. Angstadt has a great bedside manner, a cheerful disposition and is very knowledgeable. He was genuinely concerned for me, he answered all of my questions and put me at ease. I couldn’t be happier, I think it is the best decision I ever made."

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"I was concerned about my health, my blood pressure, cholesterol, my mobility, my flexibility. A few friends told me about NYBG and I went to a seminar. I wanted to live a healthier life and live a long life. My recovery was great, after a week I was 100%. My doctor, Dr. Sekhar, has the best personality in the world."

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"I had a couple of friends who had bariatric surgery done by Dr. Garber a few years back and I decided to make the appointment. My favorite thing about the surgery is not being able to eat that much, eating whatever I want but in smaller portions. My results are amazing"

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*Individual results may vary.

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