Gastric Sleeve Revision FAQ

A gastric sleeve revision is a second surgery done to adjust your original sleeve gastrectomy. It can correct problems such as severe acid reflux, a stretched stomach, or weight regain. Dr. El Djouzi may reshape the sleeve or convert it into another procedure, like a gastric bypass or duodenal switch. The goal is to give you another chance at lasting results.

People who regain significant weight, develop severe reflux, or experience other complications after a sleeve may qualify for revision. Candidates usually still meet bariatric surgery guidelines, like having a BMI over 30 with health problems. Dr. El Djouzi will also consider overall health, lifestyle commitment, and whether there are clear anatomical issues such as a stretched sleeve. If these factors line up, a revision may be a good option.

The two biggest reasons are weight regain and acid reflux. Over time, the stomach can stretch, or patients may not lose enough weight from the first surgery. Some also develop new issues like ulcers or swallowing problems. When this happens, Dr. El Djouzi may recommend a revision to correct the problem and restore results.

Options include re-sleeving (making the stomach smaller again), converting to gastric bypass, switching to a duodenal switch or SADI-S, or choosing an endoscopic tightening procedure. Each option has unique benefits depending on whether your issue is reflux, weight regain, or anatomy. Dr. El Djouzi will recommend the best path based on your specific needs and health history.

There's no single best option because it depends on your situation. For weight regain without reflux, a re-sleeve may work. For reflux or modest weight loss, gastric bypass is often recommended. If maximum weight loss is needed, a duodenal switch or SADI-S may be more effective. Dr. El Djouzi tailors the choice to your body and health goals.

Yes, a re-sleeve is possible if your stomach has stretched over time. Dr. El Djouzi can remove more of the stomach to restore fullness and help with weight loss. It works best when the stomach is clearly enlarged. However, if you also have reflux, bypass or another option may be better. Tests like an endoscopy help Dr. El Djouzi decide if a re-sleeve is right for you.

Both options are effective, but they suit different needs. Gastric bypass is often chosen for patients with severe reflux and provides good weight loss with fewer nutritional risks. Duodenal switch or SADI-S usually leads to the most weight loss but requires stricter vitamin and diet management. Dr. El Djouzi will help you weigh your health needs and long-term commitment before deciding.

SADI-S, or Single Anastomosis Duodeno-Ileal bypass with sleeve, is a simplified version of the duodenal switch. It reduces stomach size and reroutes part of the intestines to promote more weight loss and improve conditions like diabetes. It can be performed after a sleeve as a revision. While effective, it requires lifelong vitamins and can change bowel habits. Dr. El Djouzi may recommend it for patients who need stronger results.

Yes, some patients qualify for an endoscopic sleeve revision. This is done through the mouth with an endoscope and stitches to shrink the stomach from the inside, with no cuts or scars. Recovery is quicker and risk is lower compared to full surgery. It works best for mild to moderate stretching. Dr. El Djouzi can explain if this non-surgical option is right for you.

Results vary, but many patients lose meaningful weight again after revision. With bypass or duodenal switch, weight loss can be significant, sometimes up to 70–80% of excess weight. For a re-sleeve, results are usually more modest. Dr. El Djouzi will set realistic expectations with you, since weight loss is often slower than after the first surgery.

Yes, weight loss after a revision is usually less than the first time. The body adapts after the original surgery, so the "reset" isn't as strong. Still, many patients lose about half the weight they regained, which can be enough to improve health. Dr. El Djouzi often reminds patients that revision is a tool, not a repeat of the first dramatic drop.

Yes, weight regain can happen if old habits return. The stomach can stretch over time, and high-calorie eating can undo progress. Long-term success depends on healthy eating, exercise, and follow-up care. Dr. El Djouzi works closely with patients after revision to reinforce habits that prevent regain.

Success depends on the reason for surgery and how it's defined. For reflux, converting to bypass works very well, with most patients finding relief. For weight loss, results vary, but many people lose a significant amount again. Overall, about 60–80% of patients see meaningful improvements. Dr. El Djouzi will help you understand what success looks like for your case.

For the right person, yes. If you've regained a lot of weight or developed serious problems like reflux or Barrett's esophagus, revision can improve your health and quality of life. It is still major surgery, so risks and commitment matter. Many patients of Dr. El Djouzi who went through revision are glad they did, but he emphasizes the importance of realistic expectations.

Most surgeons, including Dr. El Djouzi, recommend waiting at least 12 months after your sleeve before considering revision, unless there's a medical emergency. This allows time to recover and try lifestyle changes first. If serious complications arise, like severe reflux or a stricture, you should seek help right away. Insurance companies may also require a waiting period before approving another surgery.

In most cases, yes. Gastric bypass reroutes food and acid away from the esophagus, which often improves or eliminates reflux. Many patients notice relief quickly, sometimes right after surgery. Dr. El Djouzi considers bypass the gold-standard revision for reflux after a sleeve.

Most experts, including Dr. El Djouzi, recommend converting to gastric bypass if Barrett's is diagnosed. Barrett's is caused by long-term reflux and can lead to cancer if untreated. Bypass greatly reduces acid exposure, giving your esophagus a chance to heal and lowering risks. Dr. El Djouzi works with gastroenterologists to ensure you receive the right care.

Risks include bleeding, infection, leaks at the staple line, and blood clots. Because it's a second surgery, complications can be slightly higher than the first time. Each type of revision has its own risks too, like ulcers with bypass or vitamin deficiencies with duodenal switch. Dr. El Djouzi carefully reviews risks and takes precautions to keep them low.

Yes, revisions are usually more complex due to scar tissue and altered anatomy. This can increase the risk of leaks, infections, or longer recovery. Still, in Dr. El Djouzi's experienced hands, revision is generally safe. He has developed a strong focus on bariatric revisions over the past 15+ years.

Possibly. Dumping happens when food moves too quickly into the intestine, causing dizziness, cramps, or diarrhea. It's more common after bypass than sleeve, and less so with duodenal switch. Many patients learn to avoid it by limiting sugary foods. Dr. El Djouzi provides guidance on how to manage and minimize symptoms if they occur.

Yes. Both bypass and duodenal switch reduce nutrient absorption, so daily vitamins are essential for life. This often includes multivitamins, calcium, iron, B12, and fat-soluble vitamins like A, D, E, and K. Bloodwork will be checked regularly to adjust supplements. Dr. El Djouzi emphasizes lifelong supplement use to protect your health.

Most patients stay in the hospital 1–3 days, then take 1–2 weeks off work. Full recovery usually takes about 4 weeks, depending on the type of revision. Endoscopic revisions have much shorter recovery times, sometimes just a few days. Light walking is encouraged early, but heavy lifting and intense activity are delayed until Dr. El Djouzi clears you.

Yes, the diet stages are very similar. You'll start with liquids, then slowly add puréed foods, soft foods, and finally regular meals over several weeks. High protein and low sugar are emphasized, and you'll need to eat slowly and chew well. Dr. El Djouzi and his dietitian team will guide you through each stage.

Yes, pregnancy is possible after a revision, but Dr. El Djouzi recommends waiting 12–18 months. This allows your weight and nutrition to stabilize. Getting pregnant too soon after surgery may put both you and your baby at risk. With proper timing and monitoring, most women have healthy pregnancies after revision.

Usually yes. Insurance often requires repeating steps like nutrition counseling, psychological evaluation, and sometimes a supervised diet program. Dr. El Djouzi also needs updated tests to confirm it's safe to operate and to show insurance the revision is necessary. It can feel repetitive, but it ensures safety and approval.

Many insurance plans do cover revisions if they're medically necessary. Proof of complications like severe reflux, Barrett's, or inadequate weight loss is usually required. Each insurer has different rules, so coverage can vary widely. Dr. El Djouzi's team is very familiar with this process and will guide you step by step.

Insurers typically need medical records showing weight history, complications, and test results like endoscopy or imaging. A letter of medical necessity from Dr. El Djouzi is often required. Documentation of compliance with diets and follow-ups is important too. Repeat evaluations may also be needed, such as with a dietitian or psychologist.

It varies depending on the procedure you and Dr. El Djouzi decide on. Simpler procedures like endoscopic tightening may be less, while a full conversion to bypass or duodenal switch may cost more. Dr. El Djouzi's office will provide a detailed estimate and discuss payment options if needed.

Common tests include an endoscopy to look inside your sleeve, imaging studies like a barium swallow, and standard bloodwork. If reflux is a major concern, pH or motility studies may be done. These tests help pinpoint why the sleeve failed and prove to insurance that revision is necessary. Dr. El Djouzi orders these evaluations to ensure you're safe and fully prepared for surgery.

Medications like Ozempic or Wegovy can help with weight regain after sleeve surgery. Some patients benefit from them before committing to revision. However, these drugs won't fix mechanical problems like severe reflux or a stretched stomach. Dr. El Djouzi may suggest trying them as a first step, or in combination with revision for stronger results.