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Gastric Revision Surgery

Dartmouth-Hitchcock offers the gastric revision service at Dartmouth-Hitchcock Medical Center (DHMC) in Lebanon.

There are no known effective procedures for weight regain after bariatric surgery. The stomach pouch and outlet to the small intestine may get slightly larger over time following gastric bypass. However, there is no proven link between pouch and outlet size and weight gain. After sleeve gastrectomy, the stomach will stretch. This is not likely to change the feeling of fullness.

If you had previous weight loss surgery, you might be a candidate for gastric revision surgery if you're having problems related to that surgery such as recurrent vomiting and abdominal pain. With gastric revision surgey, it is sometimes possible to convert prior gastric surgery, such as a vertical banded gastroplasty, jejuno-ileal bypass, or gastric stapling to a gastric bypass, or to redo a previous gastric bypass.

A repeat surgery on the stomach is more difficult because scar tissue has formed around the stomach and organs that are in close proximity, such as the spleen, liver, and pancreas. During revision surgery, some of the scar tissue needs to be dissected free, and the process may cause injury to these organs. Patients should understand that revision surgery carries greater risk of complications.

Insurance does not pay for revision surgery that is done due to weight regain.

If you are considering revision surgery, please call 603-650-7913 for additional information. You will need to send the following information to DHMC, One Medical Center Drive, Lebanon, NH 03756:

  • An operative report and discharge summary from the initial surgery
  • A recent history and physical, which includes your health problems, allergies, medications, and current height and weight, as well as a letter of endorsement from your doctor
  • A detailed history of your weight and diet attempts

After we receive the above information, we will schedule you for an Upper GI Series (X-ray), an upper endoscopy, which must be done at DHMC. After the Upper GI Series has been reviewed, you will be contacted about further evaluation.

If you are deemed a candidate for revision, you will then proceed through the usual Steps Before Surgery. You can also attend an Introduction to the DHMC Bariatric Surgery program meeting before any testing is done, if you wish.

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