Due to the high failure rate or relapse in the medical, nutritional and pharmacological treatment it is considered bariatric surgery as a treatment of choice for the management of severe obesity (BMI> 35). Currently surgery is considered as the only effective and lasting treatment for morbid obesity. It is recommended to consider surgical procedures where the surgical and multidisciplinary team trained and appropriate care institution in resources there. These surgical procedures are classified into three types: restrictive, malabsorptive or mixed (combination of restrictive and malabsorptive). Restrictive procedures are those that reduce stomach capacity, including the gastric band and sleeve gastrectomy.


They should consider the following points: age, sex, type of room, added to obesity pathology, patients expectations and patient preference for the type of surgery performed.

The goal of surgery for obesity is improving the health of the patient. Improving the quality of life and increasing survival. It is not a cosmetic surgery (this is a side effect of weight loss).

Traditional Bariatric Surgery is today the first option for patients with severe obesity.



  • Preoperative studies: Electrocardiogram, chest X-ray and laboratory
  • Preoperative medical evaluation
  • Rating for Psychology
  • Rating for Nutrition and nutritional monitoring
  • Hospitalization 2-3 nights depending on the procedure performed.

We perform the procedures in the Hospital Angeles Tijuana, Hospital certifed by the General Health Council.


Can be:

  • Patients who had successful weight loss with the previous procedure
  • Patients successfully, but with reganancia
  • Patients with successful weight loss, but with complications.

It can be classified:

  • Converting a bariatric surgical procedure to another
  • Review of a procedure without conversion
  • Revert surgery
  • Exploration.

Candidates for bariatric surgery patients review:

VBG, gastric plication, sleeve gastrectomy, gastric bypass or gastric band without success in weight loss or weight gain. Complications of primary surgery: gastric reflux, slide / erosion of gastric banding, gastric pouch dilation, leaks, obstruction, ulcers. It is estimated that 10-20% of patients undergoing bariatric surgery, surgery merited reganancia weight secondary to primary or complications revision procedure.

Failure of weight loss in bariatric surgery:

When the patient does not achieve> 50% loss of excess weight and / or the patient is unable to reach a BMI. No resolution or restitution of associated comorbid hypertension, diabetes, back pain and bone and joint, among others.

Patient assessment before revision surgery:

If possible determine the reason for failure.

Is the patient followed the post operative nutritional instructions?

A test radiological imaging (fluoroscopy) is required to assess the anatomical structures and in some cases a study of endoscopy may be necessary to determine the best approach. The surgeon will inform the patient of the need, risks and benefits involved in revision surgery and the importance of monitoring by the multidisciplinary team. Since 1998 IFSO (International Federation for the Surgery of Obesity) suggested: “Bariatric surgery revision is a very complex and demanding area that requires considerable bariatric surgical experience” It is mandatory that patients requiring revisional bariatric surgery are treated by a multidisciplinary group with surgical experience and a senior center.

Surgery bariatric revision increases morbidity and mortality due to age, weight, body mass index, type of fat distribution, medical conditions, type of previous bariatric surgery, hospital facilities and experience of the surgeon and multidisciplinary team. Usually done laparoscopically, open surgery may be necessary in case of adhesions from previous bariatric surgery. With the increased number of weight loss surgeries that are performed each year, an increasing number of people requiring surgía de revisión.