Revision bariatric surgery is a specialized surgical intervention that modifies or converts a previous weight loss procedure to address complications, insufficient weight loss, or weight regain. At our practice, we understand that considering revision surgery often comes after a challenging journey with your initial bariatric procedure and careful reflection on your ongoing weight management goals. Our commitment is to provide expert, compassionate care, ensuring you understand and feel supported throughout your revision surgery. This procedure effectively addresses issues such as inadequate weight loss, significant weight regain, complications from the original surgery, or the need to convert to a different bariatric procedure for improved results.
At Lifetime Surgical, our revision bariatric surgery approach utilizes the state-of-the-art DaVinci robotic surgical system, offering unmatched precision, enhanced visualization, and superior control in the challenging environment of previously operated anatomy. We employ careful surgical planning, precise tissue handling, and comprehensive pre- and post-operative support, resulting in the resolution of complications and renewed progress toward weight loss goals. The robotic approach provides additional benefits including smaller incisions, reduced post-operative pain, minimal scarring, and faster recovery time even in these more complex surgical cases. Our multidisciplinary team guides you through the entire process, from pre-surgical evaluation through post-operative lifestyle adaptation, ensuring the best possible outcomes for your individual health goals.
You may be a candidate for revision bariatric surgery if you experience:
Insufficient Weight Loss or Weight Regain:
Failure to lose at least 50% of excess body weight after initial procedure
Regain of more than 25% of the weight initially lost
Return of obesity-related health conditions that had initially improved
Continued BMI > 35 with obesity-related health conditions despite compliance
Anatomical Complications:
Severe, persistent acid reflux (especially after sleeve gastrectomy)
Chronic nausea or vomiting
Excessive restriction causing food intolerance or malnutrition
Inadequate restriction allowing for excessive food intake
Ulcers at surgical connections that don't heal with medical management
Strictures or stenosis causing difficulty swallowing or frequent vomiting
Chronic abdominal pain related to your bariatric procedure
Internal hernia causing intermittent abdominal pain or obstruction
Persistent dumping syndrome that severely affects quality of life
Severe malnutrition despite proper supplementation
Gastric band complications (slippage, erosion, port issues, band intolerance)
Fistula formation between stomach pouch and excluded stomach
Other Considerations:
Your previous bariatric procedure was performed using outdated techniques
Persistent or recurrent diabetes or other metabolic conditions
Significant decrease in quality of life related to the original procedure
Restored normal anatomy needed for medical reasons (medication absorption, etc.)
Strong commitment to the postoperative lifestyle changes needed for success
Our approach to revision bariatric surgery combines surgical excellence with comprehensive care throughout your renewed weight loss journey. The procedure begins with a thorough diagnostic evaluation including a detailed history, advanced imaging, endoscopy, and sometimes exploratory surgery to precisely identify the issues with your previous bariatric procedure. We are distinguished in our use of the advanced DaVinci robotic surgical system combined with our specialized expertise in the unique challenges of revision surgery.
The DaVinci robotic platform offers specific advantages that are particularly valuable in revision cases, where scarring and altered anatomy make surgery more complex. The robot's articulating instruments provide enhanced dexterity and range of motion beyond what human hands can achieve, allowing for more precise dissection through scar tissue and delicate handling of thinned or adhered tissues. The system's high-definition 3D visualization gives our surgeon unprecedented views of the surgical field with 10x magnification, enabling meticulous identification of critical structures that may be displaced or obscured by previous surgery.
Using the DaVinci system, we make 5-6 tiny incisions (typically 8mm or smaller) in the abdomen, resulting in minimal additional scarring compared to traditional approaches. Our revision procedures are customized to your specific situation and may include:
For previous gastric band: Band removal and conversion to sleeve gastrectomy or gastric bypass
For previous sleeve gastrectomy: Conversion to gastric bypass or duodenal switch, or re-sleeve for dilated sleeve
For previous gastric bypass: Pouch or stoma revision, limb length adjustments, or conversion to distal bypass
For specific complications: Targeted repair of hernias, strictures, ulcers, or fistulas with reinforcement of tissue
Our distinctive robotic approach includes:
Unprecedented surgical precision that ensures secure reconstructions in challenging scarred tissue
Enhanced 3D visualization allowing for safer dissection through adhesions
Reduced tissue trauma leading to less post-operative pain and faster recovery
Careful testing of all connections during surgery to ensure there are no leaks
Precise dissection techniques that preserve blood supply to compromised tissues
Meticulous closure of all potential spaces to prevent recurrent complications
Minimal scarring with significantly smaller incisions despite the complexity of revision surgery
The robotic advantage translates to patient benefits including:
Reduced post-operative pain even in these more complex cases
Lower risk of complications, particularly crucial in previously operated fields
Shorter hospital stay (typically 1-3 days depending on the specific revision)
Faster return to normal activities
Minimal additional scarring for improved cosmetic results
Reduced risk of wound complications, particularly important in bariatric patients
Throughout your care journey, our comprehensive program includes:
Detailed analysis of factors contributing to current issues before attempting surgical revision
Nutritional assessment and rehabilitation before surgery when malnutrition is present
Customized dietary and exercise plans developed with our bariatric specialists
Regular follow-up visits to monitor progress and address any concerns
Long-term monitoring for nutritional deficiencies with appropriate supplementation
This integrated approach combining robotic surgical excellence with comprehensive care ensures the best possible outcomes from your revision procedure, addressing both the technical surgical aspects and the lifestyle factors necessary for long-term success with your revised bariatric procedure.
Immediate Post-Procedure (1-5 days)
Expect a hospital stay of 1-3 days depending on the specific revision procedure performed
Experience less post-operative pain than might be expected for revision surgery thanks to robotic precision
Begin with clear liquids as directed by your surgical team, typically within 24 hours if leak tests are normal
Work with nursing staff to ensure adequate hydration and medication management
Receive instruction on proper deep breathing exercises to prevent lung complications
Begin walking within hours of surgery to prevent blood clots and promote recovery
Manage discomfort with prescribed pain medication, which is typically well-controlled following robotic surgery
Experience some shoulder pain from residual CO2 gas used during surgery
Understand the importance of following post-operative instructions precisely
Receive detailed discharge instructions tailored to your particular revision procedure
Learn to recognize signs of potential complications requiring immediate attention
Understand the importance of maintaining proper hydration (typically 48-64 oz. daily)
Begin taking prescribed vitamins and minerals as directed
Prepare for your first follow-up appointment, typically scheduled 1-2 weeks after surgery
If drains were placed, receive instructions on their care and when they will be removed
Short-Term Recovery (1-4 weeks)
Return to normal activities more quickly than would be possible with traditional open revision
Resume light physical activity within days rather than weeks
Experience gradual improvement in discomfort at your small incision sites
Follow the prescribed diet progression specific to your revision type:
Generally beginning with clear liquids
Progressing to full liquids
Advancing to pureed foods
Eventually transitioning to soft foods
Focus on protein intake, typically aiming for 60-80 grams daily through appropriate forms
Take all prescribed vitamins and minerals as directed, which is critical after revision surgery
Avoid carbonated beverages, caffeine, alcohol, and straws
Sip water continuously throughout the day to maintain hydration
Attend your follow-up appointment for wound check and diet advancement
Gradually increase walking distance daily
Avoid lifting more than 10-15 pounds for 3-4 weeks
Experience continued improvement in surgical discomfort
Monitor incision sites for proper healing, which typically occurs faster with smaller robotic incisions
Begin to notice changes in hunger, fullness, and eating capacity based on your specific revision
Track food and fluid intake carefully
Report any persistent nausea, vomiting, or inability to stay hydrated
Avoid non-steroidal anti-inflammatory drugs (NSAIDs) and extended-release medications
Return to work typically within 2-3 weeks after surgery, depending on job requirements and specific revision
Long-Term Recovery (1-6 months)
Continue advancing your diet according to the program guidelines specific to your revision type
Learn to adapt to your revised digestive anatomy with appropriate eating behaviors
Practice proper meal spacing and liquid consumption timing based on your new anatomy
Establish regular eating patterns appropriate for your revised procedure
Begin a more structured exercise program as cleared by your surgeon, typically after 4-6 weeks
Attend regular follow-up appointments to monitor progress and nutritional status
Have laboratory tests to check for nutritional deficiencies relevant to your specific procedure
Continue taking recommended vitamin and mineral supplements without fail
Adjust to changes in digestion, which may differ from your previous procedure
Learn to recognize normal versus problematic symptoms with your revised anatomy
Establish sustainable eating habits for long-term success
Monitor for proper hydration and protein intake
Experience continued improvement in weight and health markers, though the pattern may be different than with primary surgery
Work with the bariatric team to address any challenges specific to your revision
Appreciate the minimal additional scarring from your robotic procedure
For band-to-bypass or band-to-sleeve conversions, adapt to the significantly different digestive processes
For sleeve-to-bypass conversions, learn to manage potential dumping syndrome
Long-Term Expectations
Expect weight loss results that vary based on:
The type of revision performed
Your pre-revision weight
The reason for revision
Your compliance with the post-revision program
Weight loss may be more gradual than with primary procedures but typically stabilizes by 18-24 months
Maintain regular follow-ups with the bariatric program:
Every 3 months during the first year
Every 6 months during the second year
Annually thereafter
Continue lifelong vitamin and mineral supplementation, which is often more critical after revision:
Complete multivitamin
Calcium citrate with vitamin D
Vitamin B12
Iron
Additional supplements as indicated by laboratory testing
Undergo regular laboratory testing to monitor for nutritional deficiencies
Expect significant improvement in complications that prompted the revision:
Resolution of GERD symptoms (for sleeve-to-bypass conversions)
Improved weight loss (for pouch/anastomotic revisions)
Eliminated band-related complications (for band removal/conversions)
Maintain healthy eating habits and regular physical activity for lasting results
Some weight fluctuation may occur as with any bariatric procedure
Additional body contouring may be desired after stabilization at new weight
Lifetime commitment to the bariatric program for optimal long-term success
Focus on celebrating improvements in health and quality of life beyond just weight
Most patients report substantial improvement in quality of life after successful revision
Annual check-ups remain important for long-term success monitoring
Expect improved comorbidity control compared to pre-revision status
Common Side Effects
Surgical discomfort for 1-3 weeks, though typically less than expected with traditional approaches
Temporary food intolerances as you adapt to revised anatomy
Fatigue during the initial recovery period
Change in bowel habits related to your specific revision procedure
Temporary nausea as your body adjusts to the revised anatomy
Feeling of restriction when eating too quickly or taking too large of bites
Bloating or gas pain during initial adjustment period
Mild dehydration requiring conscious effort to maintain fluid intake
Development of new food preferences or aversions
Temporary hair thinning during the period of rapid weight loss that may follow revision
Psychological adjustment to changes in eating capacity and habits
For gastric bypass revisions: possible dumping syndrome has increased risk with sugar or fat consumption
For conversions to malabsorptive procedures: changes in stool consistency and frequency
Heightened awareness of digestive sensations during the adjustment period
Less Common Complications
Anastomotic leak at surgical connections (higher risk in revision cases, but minimized with robotic precision)
Stenosis or narrowing at surgical connections (3-7% in revisions)
Bleeding requiring transfusion or reoperation (slightly higher risk in revision cases)
Wound infection requiring antibiotics or drainage (reduced risk with smaller robotic incisions)
Small bowel obstruction from adhesions (more common in revision cases due to existing adhesions)
Internal hernia, particularly after bypass revisions
Significant nutritional deficiencies requiring intensive supplementation
Persistent nausea or vomiting requiring medical intervention
Marginal ulcers at bypass connections
Incisional hernia at port sites (significantly reduced with robotic approach)
Venous thromboembolism (blood clots)
Persistent reflux symptoms despite revision
Gastroparesis (delayed stomach emptying)
Conversion to open procedure (rare with robotic approach but slightly higher risk in revisions)
Injury to adjacent organs during adhesiolysis (separation of existing scar tissue)
Fistula formation
Failure to achieve desired weight loss despite technical success of the revision
Need for further revision due to recurrent issues
When to Seek Immediate Medical Attention
Persistent vomiting or inability to tolerate liquids for 24 hours
Severe abdominal pain that is getting worse rather than better
Fever over 101°F (38.3°C)
Heart rate over 120 beats per minute at rest
Shortness of breath or difficulty breathing
Chest pain or rapid breathing
Severe, uncontrolled diarrhea
Excessive bleeding from incision sites
Increasing abdominal distension or bloating
Drainage of pus or foul-smelling fluid from an incision
Calf pain, swelling, or redness (potential blood clot)
Severe, persistent nausea
Jaundice (yellowing of skin or eyes)
Dark, tarry stools or bright red blood in stool
Persistent hiccups that don't resolve
Increasing redness, warmth, or drainage at incision sites
Confusion or extreme lethargy
Severe abdominal pain with back pain (potential internal hernia)
Inability to maintain adequate hydration
From your first consultation through your complete recovery, we provide:
Thorough evaluation and explanation of your condition
Clear discussion of all treatment options, including non-surgical alternatives when appropriate
Detailed pre-operative instructions to help you prepare
Compassionate care during your hospital stay or outpatient procedure
Comprehensive follow-up care and support during recovery
Ongoing availability to address questions or concerns
We understand that facing head and neck surgery can be intimidating, but you don't have to navigate this journey alone. Our team is committed to providing expert care with a personal touch, ensuring you feel supported, informed, and confident every step of the way.
Your health and wellbeing are our highest priorities, and we're honored to be part of your care team.
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All our laparoscopic procedures are performed by our highly trained surgical team using state-of-the-art equipment and techniques.
We're committed to providing you with the most advanced, minimally invasive options because we believe you deserve:
Less pain after surgery
Shorter hospital stays
Faster return to work and activities you enjoy
Smaller, less visible scars
Lower risk of complications
Better overall outcomes
Dr. Richard Nguyen is a board-certified General Surgeon with over 20 years of surgical expertise and fellowship training in Minimally Invasive and Bariatric Surgery from Vanderbilt University. Since establishing his practice in San Jose in 2007, he has pioneered innovative surgical techniques, including single-incision laparoscopic procedures and mastery of the da Vinci Robotic Surgical System. Beyond his acclaimed bariatric surgery practice, he has earned national recognition for his specialized expertise in both non-mesh and advanced mesh hernia repairs, while also serving as a critical approach surgeon for anterior spine access procedures. Dr. Nguyen combines technical precision with personalized care across multiple premier facilities throughout the South Bay Area.
I would refer Doctor Nguyen to anyone, in fact I have and they have all had the same experience as me. He is truly great. I owe all my success to Doctor Nguyen and I thank him for all the work he has done for me and continues to do so. He is extremely amazing, and I am very grateful to him.
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At 50, I now have a life I had only dreamed of a year before. My body tells me if I am done eating. This surgery is a tool that I have used to the fullest. It is not an easy way out. It still took work. But I honestly know that I would not be living this amazing new life if I didn’t step forward to embrace this life-saving surgery.
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Dr. Nguyen has changed my life completely. I feel so much better and I also feel like I’ve got control of my life again…I had high blood pressure, diabetes and cholesterol. I took at least 5 different medications for the past 30 years. NOW, after surgery I take no medications only vitamins!
Wondering which surgical procedure might be right for your condition? We're here to help you understand your treatment options and develop a personalized surgical plan. Contact our office today to schedule a consultation.
Your path to improved health may be more achievable than you think—with advanced surgical techniques leading to faster recovery, reduced complications, and a significantly enhanced quality of life.