Revisional Bariatric Surgery in Netanya and Tel Aviv: When the First Operation Did Not Help Enough

If weight did not come down enough after bariatric surgery, came back, or complications appeared, there are options. Revisional surgery adjusts, converts or reverses the earlier operation. I operate laparoscopically and first work out why the result was not achieved; I do not recommend surgery until the cause is clear.

When a second operation is considered

• insufficient weight loss or weight regain;
• reflux after sleeve gastrectomy;
• a stricture (narrowing), a fistula or a problem with a gastric band;
• nutritional deficiencies, excessive weight loss or severe side effects.

Revisional operations I perform

• Conversion of a sleeve to RYGB or OAGB;
• correction for reflux after a sleeve and for weight regain;
• band removal;
• reversal, returning to the original anatomy in severe complications.

Exactly which operation you need is decided after the work-up.

How we decide

First a full work-up: gastroscopy, contrast swallow, blood tests, a review of your nutrition and of the previous operation (bring your operative report). Then we choose the operation together with a dietitian. Revisional surgery is more complex than a first operation: scar tissue and adhesions demand careful work, and recovery can take longer. If there is no indication or there are contraindications, I do not operate, and I tell you so directly.

Risks

Risks are higher than with a first operation: bleeding, infection, leaks from the connections, vitamin deficiencies and a longer recovery. The weight result may be more modest than after the first operation. I tell you this plainly before surgery.

Where I operate and coverage

Surgery is performed at Laniado Hospital (public healthcare) and at the private hospitals Assuta, Herzliya Medical Center and Raphael. Coverage depends on your health fund and policy and is discussed at the consultation: Maccabi, Leumit (Shaban), Clalit (Mushlam), Menora, Ayalon and Clal. With other insurers, I operate only under policies that have not changed since 2016.

FAQ

Why did my weight come back?
Most often because of eating patterns, sometimes a stretched stomach or an anatomical problem. We find out before deciding.

Will the result match the first operation?
Usually it is more modest. The main goal is better health, even if you lose less weight than the first time.

Can you revise an operation done by another surgeon?
Yes. I need the operative report and a work-up.

Can weight-loss injections (GLP-1) help?
They help some patients while they take them and can be an addition. Whether you need an operation is decided after the work-up.

See also

Primary operations are described on the bariatric surgery page.