Vertical Sleeve Gastrectomy (VSG) Revision Surgery

Although Vertical Sleeve Gastrectomy (VSG) is effective for many patients, some do not lose adequate weight, therefore revision weight loss surgery may be needed to cause additional weight loss. Failure after Vertical Sleeve Gastrectomy may be caused by a couple of different factors. 

  • If a stomach has been stretched, re-sleeving of the stomach may be a sufficient revision procedure.
  • Other individuals may require the addition of metabolic and malabsorptive aspects to compliment Vertical Sleeve Gastrectomy. Procedures such as the Duodenal Switch and Ileal Transposition may be appropriate.

Most revision operations are higher risk than the first time a weight loss surgery procedure is performed. Revision of Vertical Sleeve Gastrectomy to Duodenal Switch actually carries with it less risk than performing the Duodenal Switch in a single operation for the first time. This is possible due to the fact that Vertical Sleeve Gastrectomy is one portion of the Duodenal Switch procedure. When converting to Duodenal Switch from Vertical Sleeve Gastrectomy, a significant piece of the operation has already been performed. This results in a smaller surgical procedure than performing the Duodenal Switch all at once.

Stretching of the stomach often results in additional problems other than inadequate weight loss or weight regain. The tube of the stomach may stretch in a manner that is not uniform, resulting in portions of the stomach tube being larger than others. This can cause the stomach to become shaped like an hourglass, where both the upstream and downstream portions of the stomach are large, but they are separated by a portion of the stomach that is fairly narrow. While eating may not increase as a result of a stretched stomach tube, it may cause uncomfortable and/or disordered eating. Depending on the volume of food a patient consumes at each meal and the symptoms they have, there are a couple of revision options that all result in food flowing more directly through the stomach. 

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This information has been provided by Dr. John Husted. To learn more about Dr. Husted, please visit