Modern laparoscopic theatres
JUMP TO: About · Options · Pricing · Your Pathway · Meet the Dr · FAQs
Sometimes, a previous bariatric procedure may require further treatment or adjustment. Revision bariatric surgery involves modifying, correcting, removing or converting an existing weight loss procedure and may be considered depending on a person’s individual circumstances, health and previous surgery.
At OptiWeight, Dr Ashok Gunawardene assesses your previous procedure, current symptoms, medical history and overall health before discussing whether revision surgery may be appropriate. Depending on individual circumstances, options may include removing a gastric band, converting from one bariatric procedure to another, or revising a previous gastric bypass.
Revision bariatric surgery is an operation performed to modify, correct, remove or convert a previous weight loss procedure. It may be considered when a person has experienced complications from an earlier procedure, or when further surgical treatment may be appropriate based on their individual health and circumstances.
Procedures may include gastric band removal, conversion of a gastric sleeve or band to another bariatric procedure, or revision of a previous gastric bypass. As revision surgery can involve additional risks and considerations compared with an initial bariatric procedure, a thorough medical assessment is required to determine whether it is appropriate.
The appropriate approach depends on the type of bariatric procedure you’ve previously had, why you’re considering further treatment, your current symptoms, and your overall health. Dr Ashok Gunawardene will assess these factors before discussing the available options with you.
Gastric band removal is a laparoscopic (keyhole) procedure to remove the gastric band, tubing and access port. It may be performed as a standalone procedure or combined with conversion to another bariatric procedure, depending on your circumstances.
Removing a gastric band does not prevent future weight changes. Some people may experience changes in appetite or weight following removal, and nutritional support and ongoing follow-up may form part of the management plan. Where appropriate, other treatment options can also be discussed before surgery.
In some circumstances, a gastric band may be removed and converted to a gastric bypass. This may include a Roux-en-Y gastric bypass or a one-anastomosis gastric bypass, sometimes referred to as a mini gastric bypass.
Gastric bypass surgery changes the way food passes through the digestive system and can affect the absorption of some nutrients. People who undergo gastric bypass generally require ongoing nutritional monitoring, vitamin and mineral supplementation and regular blood tests.
Dr Ashok does not perform band to sleeve conversions because a gastric band can leave scar tissue around the stomach. Creating a sleeve requires stapling through this previously scarred tissue, which may create a point of weakness in the staple line and increase the risk of a leak. As leaks can be a serious and difficult complication to treat, Dr Ashok will discuss alternative revision options where appropriate.
A sleeve gastrectomy involves permanently removing a portion of the stomach, so it cannot be restored to its original anatomical form in the same way that a gastric band can be removed. However, the sleeve can be surgically modified or converted into another procedure, such as a gastric bypass.
The choice of procedure depends on several factors, including your previous surgery, symptoms and medical history. Your history of reflux or other gastrointestinal symptoms may also be considered when discussing the type of bypass that may be appropriate.
A previous gastric bypass can be revised in different ways, depending on the reason further treatment is being considered. Options may include bypass reversal, surgical revision, or, in selected circumstances, an endoscopic procedure.
Gastric bypass reversal involves restoring the digestive tract towards its previous anatomical arrangement. It is a complex procedure and may be considered in selected circumstances, particularly where significant complications have occurred, and other management options have not been appropriate or effective. Dr Ashok will assess your individual circumstances when considering whether reversal or another treatment approach may be appropriate.
Other ways of revising a previous gastric bypass may include:
Endoscopic and surgical revision procedures have different risks, considerations and potential outcomes. Neither approach suits everyone, and a detailed assessment is required before deciding whether further treatment is appropriate.
Revision bariatric surgery is not suitable for everyone, and whether it is appropriate depends on an individual clinical assessment. Revision surgery may be considered for adults who:
Weight regain after bariatric surgery can be difficult, and feelings of shame, guilt or self blame are common. It is important not to view weight gain as a personal failure or allow these feelings to prevent you from seeking support. Further surgery is not always required. Depending on your circumstances, options may include weight loss medications and renewed support from a multidisciplinary team. If revision surgery is ultimately appropriate, it can provide an additional tool to help you get back on track.
Several factors are considered when assessing whether revision surgery may be appropriate. These may include the type and timing of the original procedure, current anatomy, nutritional status, reflux or other gastrointestinal symptoms, previous abdominal surgery and overall health.
A consultation with Dr Ashok Gunawardene can help determine whether revision surgery is appropriate for your individual circumstances.
The cost of revision bariatric surgery varies depending on the procedure, your individual circumstances and whether you have private health insurance. For self-funded patients, an all-inclusive laparoscopic revisional gastric bypass typically starts from approximately $30,000 and typically includes hospital, theatre, accommodation, consumables, surgeon, assistant surgeon and anaesthetist fees. Gastric band removal and other revision procedures are quoted individually.
If you have appropriate private health insurance, often a Gold tier policy, your health fund may cover some hospital and theatre costs, which may reduce your out-of-pocket expenses. You remain responsible for any policy excess and for the surgeon, anaesthetist and assistant fees not covered by your fund. Medicare and private health fund rebates may also be available for eligible patients.
Following your consultation, the OptiWeight team will provide a personalised, itemised estimate outlining the expected costs of your treatment, including follow-up care. If you have any questions about consultation fees, procedure costs, rebates or payment options, our team will be happy to discuss these with you.
Your care begins with a consultation with Dr Ashok Gunawardene, either in person or by telehealth. He will review your medical history, previous bariatric procedure, current symptoms, weight management history and overall health when assessing whether revision surgery may be appropriate for you. Where available, bringing your original operation report and recent test results can assist with this assessment.
The consultation will also provide an opportunity to discuss the proposed procedure, including its potential benefits, risks, limitations and recovery requirements. Alternatives, including non-surgical management, may also be discussed. In some circumstances, further assessment or optimisation of your health may be recommended before surgery.
Before surgery, you may require further investigations to assess your health and help plan the appropriate treatment. Depending on your medical history and symptoms, these may include a gastroscopy, imaging, blood tests, a sleep study, an echocardiogram, or oesophageal manometry.
You will also meet with an OptiWeight bariatric dietitian to discuss nutrition, eating behaviours and preparation for surgery, including the pre-operative liver-reducing diet where appropriate.
If revision surgery is appropriate and you choose to proceed, Dr Ashok will perform the procedure at Northern Private Hospital in Epping or St Vincent’s Private Hospital in Werribee. Surgery is performed under general anaesthesia, with laparoscopic (keyhole) techniques used where clinically appropriate.
Revision procedures can be more complex than primary bariatric surgery because previous operations may cause scar tissue and changes to normal anatomy. The length of surgery and hospital stay will depend on the procedure performed and your individual circumstances.
Before surgery, you will receive information about the procedure, including potential risks and complications, expected recovery and the follow-up care that may be required.
Recovery varies depending on the type of revision procedure performed and your individual circumstances. After some procedures, your diet will progress through different stages, which may include liquids, soft foods and a gradual return to a more regular diet, according to the advice of your treating team.
If your revision involves a gastric bypass, ongoing vitamin and mineral supplementation and regular blood tests are generally required because bypass procedures can affect nutrient absorption. Long-term clinical follow-up is also an important part of care.
Dr Ashok typically reviews patients at 2 weeks, 6 weeks, 12 weeks, 6 months and 12 months after surgery, with longer-term follow-up offered every 6 to 12 months. The timing and frequency of appointments may vary depending on your procedure, recovery and individual clinical needs. Patients can also contact the OptiWeight team if questions or concerns arise during their recovery.
Revision bariatric surgery is a major surgical procedure and, like all surgery, carries potential risks and complications. Revision procedures can involve additional risks compared with primary bariatric surgery because previous operations may result in scar tissue, adhesions and changes to the normal anatomy. Potential risks and complications may include:
This is not a complete list. Dr Ashok will discuss the risks, expected benefits and alternatives relevant to your individual circumstances before any surgery.
FRACS
MBChB Hons
GESA
PhD
ANZMOSS
Dr Ashok Gunawardene is a registered specialist general surgeon with subspecialist training in upper gastrointestinal and weight loss surgery. With over 15 years of clinical experience across the United Kingdom, New Zealand and Australia, he brings a considered, evidence-informed approach to weight management care.
Dr Ashok is accredited by the Gastroenterological Society of Australia (GESA) in upper and lower gastrointestinal endoscopy, holds a PhD in surgical research and is an Examiner for the Royal Australasian College of Surgeons. He is a member of the Australia and New Zealand Metabolic and Obesity Surgery Society (ANZMOSS) and the International Federation for the Surgery of Obesity and Metabolic Disorders (IFSO), and contributes to the Bariatric Surgery Registry.
As Director of OptiWeight, Dr Ashok supports patients through both surgical and non-surgical treatment pathways, helping them understand their options and make informed decisions about their health. His approach focuses on ensuring patients feel supported, informed and respected throughout their care.
“My approach is simple: I want every patient to feel safe, supported, and never rushed. Surgery is a tool – your long-term health is the goal.”
Considering revision bariatric surgery is a significant decision. A private consultation with Dr Ashok Gunawardene allows you to ask questions, discuss your health history and understand whether a revision procedure may be appropriate for your circumstances. Dr Ashok will explain the potential benefits, risks, alternatives and follow-up requirements before any treatment pathway is planned.
Revisional bariatric surgery involves modifying, correcting, removing or converting a previous bariatric procedure. Where clinically appropriate, many revision procedures are performed laparoscopically (using keyhole techniques). The approach depends on the type of previous surgery, the current anatomy and the reason revision is being considered. Surgery may involve removing a device, addressing a complication, modifying part of the previous procedure or converting to a different bariatric procedure.
Revisional bariatric surgery does not treat a single condition. It may be considered when complications, symptoms or other concerns arise following a previous bariatric procedure.
After gastric band surgery, potential reasons for revision may include band slippage or erosion, problems with the port or tubing, reflux or difficulty swallowing. After a gastric sleeve or gastric bypass, revision may be considered for problems such as narrowing, ulcers, reflux, dumping symptoms, or nutritional complications.
Revision may also be considered in some circumstances where weight-related health conditions persist or recur following inadequate weight loss or weight regain. However, weight regain does not necessarily mean that further surgery is appropriate. Depending on the circumstances, dietary, medical or behavioural management may also be considered.
The potential benefits of revision surgery depend on the reason for the procedure and vary between individuals. In some cases, revision may address complications or symptoms from a previous operation, such as reflux or swallowing difficulties, or involve removing a device that is causing problems.
If a previous procedure is converted to another type of bariatric surgery, it may also affect weight and some weight-related health conditions. The extent of any benefit varies between individuals and cannot be predicted or guaranteed.
Gastric band removal is a recognised surgical procedure, but like all surgery, it carries potential risks and complications. Risks associated with band removal may include injury to the stomach when the band is separated from surrounding scar tissue, increased complexity where the band has eroded into the stomach, infection, bleeding, hernia at the port site and changes in reflux symptoms or weight following removal.
Your individual risks depend on factors including how long the band has been in place, its position, whether it has slipped or eroded, any previous abdominal surgery and your overall health. Dr Ashok will assess these factors and discuss the potential risks before surgery.
Gastric band removal is performed under general anaesthesia, usually using laparoscopic (keyhole) techniques. Small incisions are made in the abdomen to allow a camera and surgical instruments to be inserted. The band is carefully separated from the surrounding tissue before being removed, along with the associated tubing. The access port beneath the skin is also removed.
If conversion to another bariatric procedure is planned at the same time, the additional procedure will then be performed. In some circumstances, it may be necessary to convert from laparoscopic surgery to an open operation.
The duration of gastric band removal varies depending on factors such as the amount of scar tissue, the position and condition of the band, previous abdominal surgery and whether another procedure is performed at the same time.
The length of the hospital stay also varies. Some patients may be able to go home on the day of surgery, while others may require an overnight or longer hospital stay. Recovery time depends on the individual and the type of procedure performed. Dr Ashok will discuss the expected surgical and recovery time with you as part of your pre-operative planning.
Some discomfort is expected following gastric band removal. This may include discomfort around the abdominal and port-site incisions, bloating or shoulder-tip discomfort associated with the gas used during laparoscopic surgery.
Pain relief will be provided as part of your post-operative care. The level and duration of discomfort vary between individuals and may differ when band removal is combined with another procedure.
This page is general information only and is not a substitute for personalised medical advice. Weight loss surgery and non-surgical weight loss are significant decisions with benefits and risks that differ for each person. Outcomes vary and cannot be guaranteed. Please consult Dr Ashok Gunawardene or your GP to discuss whether a procedure is appropriate for your individual circumstances.
