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REVISIONAL BARIATRIC SURGERY

 OUR APPROACH TO 
REVISIONAL BARIATRIC SURGERY
HAS YOUR STOMACH POUCH STRETCHED OUT PREVENTING WEIGHT LOSS, OR CAUSING WEIGHT GAIN?

For those who find themselves in the disheartening position of not achieving their desired weight loss or experiencing weight regain, the struggle is real, and often, their pleas for assistance go unheard. Too frequently, they are directed to nutritionists or left to navigate their weight loss journey alone, only to discover that conventional methods yield fleeting results at best. This unfortunate narrative echoes in our consultations with patients who turn to us in search of genuine help. Dr. Mehta offers hope with over two decades of expertise in revision surgeries, refining techniques to minimize invasiveness and maximize effectiveness. Among the common issues encountered, many individuals present with an enlarged stomach pouch following gastric bypass or sleeve procedures. While a multitude of treatments exist, not all deliver the desired outcomes. 



THERE ARE A FEW TREATMENT OPTIONS... SOME BETTER THAN OTHERS:
 
Endoscopic stitching of the pouch:
Endoscopic stitching within the stomach pouch refers to inserting an endoscope through the mouth into the stomach and using a device to stitch the gastric sleeve or bypass pouch smaller.  Although it seems promising to patients, this method often falls short, offering limited weight loss and transient results due to the inherent weakness of the stomach lining. The sutures often don't hold up long term, and the minimal weight that was lost is regained. 


Laparoscopic Plication of gastric sleeve or gastric bypass pouch:
Our laparoscopic plication technique involves folding the stomach's full thickness wall inward, creating a substantially smaller pouch, surpassing the original surgery's dimensions if necessary. This meticulously modified approach has consistently demonstrated its efficacy in driving sustainable weight loss outcomes. Since the entire thickness of the stomach is folded inwards, the stitches last unlike the endoscopic suturing, and the weight loss is greater.  With our laparoscopic approach, we use the same incisions you had during your initial surgery. 


Switching to a different surgery: While this can be a good option in some cases, it's not the standard for all. There is a long list of options below. These need to be discussed with the patient and the right option is chosen to achieve the desired outcome. There's a difference between who's had weight loss surgery and is 40 pounds shy of reaching their goal weight verses someone who is 80 pounds away. They would very likely need different procedures for optimal outcomes.


Adding a gastric band to the gastric bypass:
This can be an option for someone who had a gastric bypass with sub-optimal outcome. The option to make the pouch smaller using our Plication technique, placing a gastric band over it, or both.

MORE REVISION SURGERY OPTIONS 

FAILED GASTRIC SLEEVE OPTIONS
  • ​Plication (Infolding) of Gastric Sleeve 
  • ​Partial resection of Gastric Sleeve
  • ​Endoscopic Suturing of Gastric Sleeve
  • ​Conversion to Gastric Bypass 
  • ​Co​nversion to Long Limb Gastric Bypass (Aka: Distal Gastric Bypass)
  • ​​Conversion to Duodenal Switch
FAILED GASTRIC BYPASS OPTIONS
  • ​Revision Plication of Gastric Bypass Pouch and Outlet
  •  Lap-Band over Gastric Bypass
  •  Combination: Revision Plication of Gastric Bypass with Lap band placed over Gastric Bypass 
  •  Revision Plication of Gastric Bypass with increasing the amount of intestine bypassed. (aka: Long limb gastric bypass, or Distal Gastric Bypass)
FAILED LAP-BAND
OPTIONS
  • Removal of band w/ conversion to a Gastric Sleeve
  • Conversion to Mini-Gastric Bypass
  • Conversion to Gastric Bypass
  • ​Conversion to Long Limb Gastric Bypass (Aka: Distal Gastric Bypass)
  • ​Conversion to Duodenal Switch

PLICATING (INFOLDING) OF GASTRIC SLEEVE

In this video as we address the issue of a stretched gastric sleeve. Through meticulous folding and stitching, we not only restore its integrity but also enhance its efficacy by rendering it even smaller than its original state. This innovative procedure, devoid of any incisions on the stomach or intestines, can be completed in just 45 minutes, allowing patients to resume their daily routines within 2-3 days. The same remarkable transformation can be applied to stretched gastric bypass cases. By opting for these revision surgeries, you bypass the need for extensive re-cutting of vital organs, while ensuring the creation of a finely tuned stomach pouch that facilitates maximal weight loss. Moreover, for those seeking even greater weight loss and long-term restriction, the option to incorporate a Lap-Band into the revision procedure stands readily available. Our commitment lies in tailoring each procedure to your unique requirements, ensuring optimal outcomes and personalized care every step of the way. Choose Dr. Mehta for your revision surgery and embark on a journey towards renewed health and vitality.
Often, people are who either didn't lose enough weight or have regained weight are desperately seeking help, but have not been taken seriously. Their voice often feels ignored as they are often referred to a nutritionist, or are left on their own means to try and lose weight, which simply doesn't produce any significant or lasting results. Unfortunately, we hear this all too often as patients seek us out searching for help. Since revision procedures can require highly specific expertise, it comes as no surprise that many practices choose to not perform revisions at all, or do them infrequently. Dr. Mehta specializes in diagnosing and fixing such bariatric surgery issues, and has been doing so for 20+ years. We routinely get patients that travel from other states and abroad to get help in complex cases. This level of expertise is learned over 2 decades of specializing & treating thousands of patients.  

HAS YOUR STOMACH POUCH STRETCHED OUT PREVENTING WEIGHT LOSS, OR CAUSING WEIGHT GAIN?

For those who find themselves in the disheartening position of not achieving their desired weight loss or experiencing weight regain, the struggle is real, and often, their pleas for assistance go unheard. Too frequently, they are directed to nutritionists or left to navigate their weight loss journey alone, only to discover that conventional methods yield fleeting results at best. This unfortunate narrative echoes in our consultations with patients who turn to us in search of genuine help. Dr. Mehta offers hope with over two decades of expertise in revision surgeries, refining techniques to minimize invasiveness and maximize effectiveness. Among the common issues encountered, many individuals present with an enlarged stomach pouch following gastric bypass or sleeve procedures. While a multitude of treatments exist, not all deliver the desired outcomes. 

THERE ARE A FEW TREATMENT OPTIONS... SOME BETTER THAN OTHERS:
 
Endoscopic stitching of the pouch:
Endoscopic stitching within the stomach pouch refers to inserting an endoscope through the mouth into the stomach and using a device to stitch the gastric sleeve or bypass pouch smaller. Although it seems promising to patients, this method often falls short, offering limited weight loss and transient results due to the inherent weakness of the stomach lining. The sutures often don't hold up long term, and the minimal weight that was lost is regained. 

Laparoscopic Plication of gastric sleeve or gastric bypass pouch:
Our laparoscopic plication technique involves folding the stomach's full thickness wall inward, creating a substantially smaller pouch, surpassing the original surgery's dimensions if necessary. This meticulously modified approach has consistently demonstrated its efficacy in driving sustainable weight loss outcomes. Since the entire thickness of the stomach is folded inwards, the stitches last unlike the endoscopic suturing, and the weight loss is greater. With our laparoscopic approach, we use the same incisions you had during your initial surgery. 

Switching to a different surgery: While this can be a good option in some cases, it's not the standard for all. There is a long list of options below. These need to be discussed with the patient and the right option is chosen to achieve the desired outcome. There's a difference between who's had weight loss surgery and is 40 pounds shy of reaching their goal weight verses someone who is 80 pounds away. They would very likely need different procedures for optimal outcomes.

Adding a gastric band to the gastric bypass:
This can be an option for someone who had a gastric bypass with sub-optimal outcome. The option to make the pouch smaller using our Plication technique, placing a gastric band over it, or both.
Above is a video of a gastric sleeve which had stretched out over the years. The sleeve is folded inwards & stitched making it even smaller then the original. There is no cutting of the stomach or the intestines.  This procedure takes about 1.5 hrs, and patients can return to work in 2-3 days. The same can be done if your gastric sleeve has stretched out. These revision cases were modified thereby eliminating re-cutting of the stomach or intestine, and creating a tiny stomach pouch for maximal weight loss. Additionally, a Lap-Band can be added to the revision procedure for greater weight loss & long term restriction. We discuss the options and tailor the procedure to best meet your needs.

REVISION OPTIONS 

FAILED GASTRIC SLEEVE OPTIONS
  • ​Plication (Infolding) of Gastric Sleeve 
  • ​Partial resection of Gastric Sleeve
  • ​Endoscopic Suturing of Gastric Sleeve
  • ​Conversion to Gastric Bypass 
  • ​Co​nversion to Long Limb Gastric Bypass (Aka: Distal Gastric Bypass)
  • ​​Conversion to Duodenal Switch
FAILED GASTRIC BYPASS OPTIONS
  • ​Revision Plication of Gastric Bypass Pouch and Outlet
  •  Lap-Band over Gastric Bypass
  •  Combination: Revision Plication of Gastric Bypass with Lap band placed over Gastric Bypass 
  •  Revision Plication of Gastric Bypass with increasing the amount of intestine bypassed. (aka: Long limb gastric bypass, or Distal Gastric Bypass)
FAILED LAP-BAND
OPTIONS
  • Removal of band w/ conversion to a Gastric Sleeve
  • Conversion to Mini-Gastric Bypass
  • Conversion to Gastric Bypass
  • ​Conversion to Long Limb Gastric Bypass (Aka: Distal Gastric Bypass)
  • ​Conversion to Duodenal Switch
IS REVISION SURGERY SAFE?
Revision surgeries have come a long way. For over 2 decades, we've been performing these procedures laparoscopically, using tiny skin incisions and cameras.  We have modified the older procedures in an effort to making them safer overall. Instruments and surgical staplers have also improved over this time period adding to the safety. And of course surgery experience adds to patient safety. You should know that a lot of patients have successfully undergone some type of revision procedure through us, as this a very common part of our surgical practice.


HOW MUCH WEIGHT WILL I LOSE?
Overall weight loss depends on many factors. Since you are unique, and so is your weight loss journey, diet & lifestyle, how much weight you will lose can only be estimated after putting your entire picture together, and gathering information about the bariatric surgery you had. Dr. Mehta usually starts by performing an endoscopy himself to evaluate your prior surgery. 


HOW MUCH TIME OFF IS NEEDED?
20 years ago, when people underwent an open revision surgery, they would be expected to stay in the hospital for 7 to 10 days.  Now most of our patients go home the either same day, or require 1 overnight stay. Most people can resume work from home in 2 days or go to a desk job in about 3-4 days depending on the type of surgery they had. 


DOES INSURANCE COVER REVISION SURGERY?
In our experience, revision bariatric surgeries are usually covered by insurance. Once we contact your insurance company, we find out exactly what is covered, and can give you details. We do not proceed without your consent, and we do not send anyone surprise bills at the back end.  If needed, financing is also available which can be paid off over several years.


IF INSURANCE DOESN'T COVER SURGERY, WHAT ARE MY OPTIONS?
1. Options include upgrading insurance which usually happens in November for most people. You can contact us and find out which insurance benefits would best fit you.  
2. Self-Pay is also an option. We have package fees that include everything... consultation, hospital OR, anesthesia, surgery, medications, overnight stay...etc. 
3. Our office can sometimes get insurances to cover part of the procedure using "Split-authorization". This could save you a large amount.
4.  Financing is available using Care Credit and Health Care Services Loans.  These loans can be paid back on your time line.

IS REVISION SURGERY SAFE?
Revision surgeries have come a long way. For 18 years, we've been performing these procedures laparoscopically, using tiny skin incisions and cameras.  We have modified the older procedures in an effort to making them safer overall. Instruments and surgical staplers have also improved over this time period adding to the safety. And of course nearly 2 decades of revision surgery experience adds to patient safety. You should know that a lot of patients have successfully undergone some type of revision procedure through us, as this a very common part of our surgical practice.


HOW MUCH WEIGHT WILL I LOSE?
Overall weight loss depends on many factors. Since you are unique, and so is your weight loss journey, diet & lifestyle, how much weight you will lose can only be estimated after putting your entire picture together, and gathering information about the bariatric surgery you had. Dr. Mehta usually starts by performing an endoscopy himself to evaluate your prior surgery. 


HOW MUCH TIME OFF IS NEEDED?
20 years ago, when people underwent an open revision surgery, they would be expected to stay in the hospital for at least a week to 10 days.  Now most of our patients go home the either same day, or require 1 overnight stay. Most people can resume work from home in 2 days or go to a desk job in about 3-4 days depending on the type of surgery they had.  Those who can take more time off, generally take a week.


DOES INSURANCE COVER REVISION SURGERY?
In our experience, revision bariatric surgeries are usually covered by insurance. Once we contact your insurance company, we find out exactly what is covered, and can give you details. We do not proceed without your consent, and we do not send anyone surprise bills at the back end.  If needed, financing is also available which can be paid off over several years.


IF INSURANCE DOESN'T COVER SURGERY, WHAT ARE MY OPTIONS?
1. Options include upgrading insurance which usually happens in November for most people. You can contact us and find out which insurance benefits would best fit you.  
2. Self-Pay is also an option. We have package fees that include everything... consultation, hospital OR, anesthesia, surgery, medications, overnight stay...etc. 
3. Our office can sometimes get insurances to cover part of the procedure using "Split-authorization". This could save you a large amount.
4.  Financing is available using Care Credit and Health Care Services Loans.  These loans can be paid back on your time line.

WHAT OUR REVISION PATIENTS ARE SAYING:
WHAT OUR REVISION PATIENTS ARE SAYING:

Lap Band over Gastric Bypass

Lulu, our office managerhad Bariatric Surgery 19 years ago & Gastric Band over Gastric Bypass 10 yrs agoShe has been maintaining her ideal weight since & can be reached at the office if you'd like to discuss regarding weight loss surgery or a revision option. She is extremely friendly and knows first hand the daily suffering of obese people as she once weighed 300 lbs.


"Dr. Mehta and his staff (especially Lulu) are great!! Dr. Mehta has a great bedside manner and takes the time to talk to you and answer any and all questions that you may have. My situation was different than most. I had an old gastric banding placed in back in 1985. My surgery was performed by a surgeon who no longer practices. I had gone to many doctors and finally met Dr. Mehta who decided to help me by performing corrective surgery to remove the band and perform the new gastric bypass. I was back up to 225 lbs and I am now down to 140 lbs. I had the surgery and I am now feeling great and no longer in pain. I love Dr. Mehta and his staff. I felt I made a great choice and I am glad he took my case on and helped me out." 
- COLLEEN V. FLEMINGTON, NJ 

Revision Infolding of Gastric Sleeve

"Having a revision bariatric surgery by Dr. Mehta has completely changed my life. My eating habits are a lot better. I have tons of energy, can breathe easier without being out of breath, and I’m off my blood pressure medications. I’ve been a softball coach for 30 years. Now, I can hit, run and throw with the girls at practice. My aches and pains are gone. My daily walks are painless and my smile is as big as ever. Thank you Dr. M!"

-Ray
After a lifetime of losing and gaining weight, including a "stomach-stapling" surgery 13 years earlier, my personal physician recommended gastric bypass surgery. The referred surgeon said I would require "open" surgery because of my previous stapling surgery, and since he only performed laparoscopic, I needed to find another surgeon. While researching I located Dr. Mehta's website and attended several of his seminars and support group meetings. These were very open discussions of the surgical procedure and the risks and benefits associated with it. It was obvious that Dr. Mehta's patients had a great respect for him as a person and in his skills as a surgeon. During my consultation, Dr. Mehta discussed the possibility of doing the revision surgery laparoscopically. Once the day of surgery was over, I was thrilled to find that the gastric bypass was successfully completed in this minimally invasive way. Without Dr. Mehta's skills and confidence to perform this surgery laparoscopically, I would have had several more weeks of pain and recovery time associated with "open" surgery. My recovery went very smoothly, and I benefited from the support I received from the support group and the wonderful office staff. The availability of a dietician and personal trainer’s gives you all the tools needed to make the most of this life changing procedure. At the time of surgery, I weighed 250 lbs. It has been nine months since surgery, and I am down 85-90 pounds (and still losing) and I feel great. I would highly recommend Dr. Mehta and his comprehensive practice to anyone seeking this type of surgery. He is an exceptional surgeon and a very caring person.
- KAT C. SOMERSET, NJ

Lap Band over Gastric Bypass

Lulu, our office managerhad Bariatric Surgery 19 years ago & Gastric Band over Gastric Bypass 10 yrs agoShe has been maintaining her ideal weight since & can be reached at the office if you'd like to discuss regarding weight loss surgery or a revision option. She is extremely friendly and knows first hand the daily suffering of obese people as she once weighed 300 lbs.


"Dr. Mehta and his staff (especially Lulu) are great!! Dr. Mehta has a great bedside manner and takes the time to talk to you and answer any and all questions that you may have. My situation was different than most. I had an old gastric banding placed in back in 1985. My surgery was performed by a surgeon who no longer practices. I had gone to many doctors and finally met Dr. Mehta who decided to help me by performing corrective surgery to remove the band and perform the new gastric bypass. I was back up to 225 lbs and I am now down to 140 lbs. I had the surgery and I am now feeling great and no longer in pain. I love Dr. Mehta and his staff. I felt I made a great choice and I am glad he took my case on and helped me out." 
- COLLEEN V. FLEMINGTON, NJ 

Revision Infolding of Gastric Sleeve

"Having a revision bariatric surgery by Dr. Mehta has completely changed my life. My eating habits are a lot better. I have tons of energy, can breathe easier without being out of breath, and I’m off my blood pressure medications. I’ve been a softball coach for 30 years. Now, I can hit, run and throw with the girls at practice. My aches and pains are gone. My daily walks are painless and my smile is as big as ever. Thank you Dr. M!"

-Ray
After a lifetime of losing and gaining weight, including a "stomach-stapling" surgery 13 years earlier, my personal physician recommended gastric bypass surgery. The referred surgeon said I would require "open" surgery because of my previous stapling surgery, and since he only performed laparoscopic, I needed to find another surgeon. While researching I located Dr. Mehta's website and attended several of his seminars and support group meetings. These were very open discussions of the surgical procedure and the risks and benefits associated with it. It was obvious that Dr. Mehta's patients had a great respect for him as a person and in his skills as a surgeon. During my consultation, Dr. Mehta discussed the possibility of doing the revision surgery laparoscopically. Once the day of surgery was over, I was thrilled to find that the gastric bypass was successfully completed in this minimally invasive way. Without Dr. Mehta's skills and confidence to perform this surgery laparoscopically, I would have had several more weeks of pain and recovery time associated with "open" surgery. My recovery went very smoothly, and I benefited from the support I received from the support group and the wonderful office staff. The availability of a dietician and personal trainer’s gives you all the tools needed to make the most of this life changing procedure. At the time of surgery, I weighed 250 lbs. It has been nine months since surgery, and I am down 85-90 pounds (and still losing) and I feel great. I would highly recommend Dr. Mehta and his comprehensive practice to anyone seeking this type of surgery. He is an exceptional surgeon and a very caring person.
- KAT C. SOMERSET, NJ

The following are Dr. Mehta's patients describing their heartfelt struggle with weight and final success.
This video was shot 20 years ago by the Mehta Bariatric Center.
Yes, we've been doing this for that long!

The following are Dr. Mehta's patients describing their heartfelt struggle with weight and final success.
This video was shot 20 years ago by the Mehta Bariatric Center.
Yes, we've been doing this for that long!

LOCATIONS IN NEW JERSEY.  COMPLIMENTARY CONSULTATIONS

PRINCETON, NJ OFFICE
1 Academy St. Princeton, NJ 08540
OLD BRIDGE, NJ OFFICE
2 Hospital Plaza, Suite 470, Old Bridge NJ

Disclaimer: This website offers generalized information which is not intended to be taken as medical advice, nor should it be substituted for speaking to our surgeon. As expected, patient's experience and results differ.