Gastric bypass, vertical sleeve gastrectomy, gastric banding, and duodenal switch are some of the most common bariatric procedures. While most of these procedures have positive outcomes, there are situations where side effects are so severe that reversal is desired. Whether you have already had gastric bypass surgery or some other bariatric surgical procedure, it is important to know your options if you are wondering whether it can be reversed.

This article will present the different types of bariatric surgical procedures, whether reversal is an option, and reasons why a bariatric surgical procedure would be reversed.

Bariatric surgery is a good option for people who haven’t been able to lose weight by other means

Bariatric surgery is an option for individuals who are considered obese and have not been able to lose weight by other methods. Typically, diet and exercise alone have not been effective, and a bariatric surgical procedure is the only option for weight loss.

There are several different types of bariatric surgery for weight loss, including gastric bypass. Like any medical or surgical procedure, there is always the possibility that an end result will not be ideal or expected. There are many possible negative outcomes or side effects that can result from bariatric surgery. These side effects can develop right after the procedure, or sometimes further down the road.

Sometimes the negative side effects are so severe that they result in the need to revise or even reverse the procedure. While reversal is possible for some bariatric procedures, it may not be possible for all of them. It is more possible for bariatric surgery reversal with certain bariatric procedures than with others.

Gastric bypass is one among several surgeries you might be considering.

Bariatric surgical procedures include:

• Roux-en-Y: This is probably the most commonly known procedure, and is also known as gastric bypass. In this procedure, a small pouch is created in the stomach. The pouch is then connected to a lower part of the small intestine. This causes food to bypass a portion of the digestive system. This procedure makes the patient feel fuller faster and for a longer time due to the smaller stomach size. Gastric bypass also prevents a portion of food from being absorbed because it bypasses part of the digestive system. This causes fewer calories to be absorbed, which leads to weight loss.
• Biliopancreatic diversion with duodenal switch: This is another form of intestinal  bypass, but it is a more complex procedure than the Roux-en-Y. It involves surgically creating a sleeve-shape out of the stomach, keeping the pylorus intact followed by division of the first portion of the small bowel (duodenum). The divided duodenum is then attached to a lower part of the intestines, bypassing a large portion of the digestive tract.
• Laparoscopic adjustable gastric banding (lap band): In this procedure, an inflatable band is placed around the top part of the stomach. This makes a smaller pouch that is now the functional stomach, restricting the amount of food that a person is able to eat. The band can be adjusted as needed to make the pouch larger or smaller.
• Sleeve gastrectomy: In this procedure, the stomach is surgically changed into a sleeve-shape that restricts the amount of food a patient can consume.

Why would someone consider gastric bypass reversal?

Most people who have gastric bypass or other bariatric surgeries have positive outcomes. This includes weight loss and reversal of the diseases and conditions related to obesity, like diabetes. However, as with any surgical procedure, there is always the possibility that bariatric surgery will not result in a desired or expected outcome. Some of these side effects can be so severe that a bariatric surgery reversal is considered.

Potential undesired or unexpected side effects of bariatric surgery include:

• Dumping syndrome
• Bowel obstruction
• Malnutrition
• Low blood sugar
• Hernias
• Stomach perforation
• Non-healing gastric ulcer
• Frequent vomiting
• Abdominal pain
• Nutritional deficiencies

Gastric bypass surgery can be reversible

Depending on the type of procedure, some bariatric surgeries can be reversed more easily than others. A gastric bypass reversal is a surgery that returns a patient’s stomach and intestines back to their original placement. With the reversal of the gastric bypass, it is important to note that weight gain and the return of previous diseases are very likely to occur.

Is reversal possible for all bariatric surgical procedures?

Due to the specifics of each gastric procedure, it is more possible to reverse certain procedures than others. However, any reversal carries a higher risk of complications and it is done only in extenuating circumstances. Some procedures are considered non-reversible.

• Roux-en-Y (gastric bypass): It can be completely reversed, but it is considered a complex surgery with many risks associated.
• Biliopancreatic diversion with duodenal switch: This procedure is the most complex bariatric procedure, and is not reversible to pre-surgical anatomy. Re-arrangements could be done to resemble normal food passage, but with some sacrifices such as loss of a portion of the stomach and partial duodenal bypass.
• Lap band: This is a reversible bariatric surgical procedure, but not without consequences. Most bands are removed due to weight gain or band complications, and therefore most of the patients require secondary revisional bariatric operations to battle obesity. The scar from the band would make ensuing operations more risky due to a higher chance of leak.
• Sleeve gastrectomy: This procedure involves the removal of part of the stomach, so is not reversible. It can be changed into a different procedure if needed.

Is bariatric surgery reversal safe?

As with any surgical procedure, bariatric surgery reversal carries the risk for complications. Because it is a second procedure, the complexity and risk increases due to the presence of scar tissue and decreased blood flow to the area.

However, even with the risk involved, some studies showed positive outcomes for patients who received gastric bypass reversal. Most of the patients who underwent gastric bypass reversal experienced relief from the side effects that led to the reversal surgery.

Are there options if I don’t want to have a reversal?

If you have severe side effects from previous gastric bypass surgery or other bariatric procedure, you should be following up closely with your surgeon and team of healthcare professionals. They will determine what your best, and safest options are. If gastric bypass reversal is not an option, it is important to discuss long term symptom management for your issues.

Bottom line: gastric bypass surgery and other bariatric surgeries can be reversed. But they are complex procedures and need to be discussed and planned thoroughly with your team of doctors to make the best decision for your health.