Surgical Revision After Sleeve Gastrectomy in Bangkok, Thailand
Surgical revision after a sleeve gastrectomy changes the existing sleeve when reflux, weight regain or too little weight loss persists. The main options are conversion to a gastric bypass, mainly for reflux; conversion to SADI-S or a duodenal switch, mainly for weight regain; and a repeat sleeve in selected cases. At YOUNIFY Clinic, a Healthy Aging & Wellness Center based in Bangkok, Thailand, revision is planned by the clinic's bariatric surgical team after a full assessment, and priced in a written quotation before any deposit.
Last updated:
At a glance
- Procedure
- Surgical revision after sleeve gastrectomy
- Starting from (THB)
- Surgical revision: Confirmed in your written quotation after assessment.
- Hospital stay
- Confirmed at consultation
- Time in Bangkok
- Confirmed at consultation
- Who performs
- Confirmed at consultation
- Where
- JCI- or AACI-accredited partner private hospital, Bangkok
- Last reviewed
- October 4, 2026
Key takeaways
- The reason for revision guides the choice. Conversion to gastric bypass is the usual surgical answer to reflux, while SADI-S tends to bring more weight loss when regain is the problem.
- In a 7-year comparison of revision for weight regain, SADI-S led to more weight loss than gastric bypass, and gastric bypass resolved reflux far more often.
- Revision carries more risk than a first operation, and SADI-S and the duodenal switch need lifelong supplements and blood tests.
- Endoscopic revision through the mouth is an alternative for some people. Every surgical revision is priced in a written quotation after assessment.
Why a sleeve is revised
A sleeve gastrectomy works well for many people, but some later need further treatment, usually for:
- Reflux (heartburn or regurgitation) that is new or worse since the sleeve and does not settle with medicines.
- Weight regain, or too little weight loss, often with a widened sleeve.
In a 2021 meta-analysis of 17 studies and 556 patients converted from a sleeve to a gastric bypass (Matar and colleagues, Obesity Surgery), about 30% of conversions were for reflux and about 52% for weight regain or too little weight loss.
Weight regain has several causes and is not a personal failure; read weight regain after sleeve gastrectomy.
How the plan is made
- Your records: sleeve operation notes, weight history and any reports, even if incomplete.
- Nutrition and blood tests, so deficiencies are corrected before surgery.
- A written quotation for the agreed plan, before any deposit.
What the evidence shows
Most evidence on revision is observational, with few randomised comparisons. These are published averages, not a prediction for you.
- Sleeve to gastric bypass, overall. The Matar meta-analysis found total weight loss of 22.8% at 1 year after conversion. Complications occurred in 16.4% within 30 days and in 11.4% after 30 days.
- Reflux after conversion to gastric bypass. In a French series (Benamran and colleagues, Journal of Gastrointestinal Surgery, 2024), 70% of patients had complete resolution of reflux symptoms and 60% had stopped acid-reducing medicines. The authors note that many restart these medicines over time.
- SADI-S compared with gastric bypass after a sleeve. A pooled analysis of seven studies with at least 5 years of follow-up (Thomopoulos and colleagues, Langenbeck's Archives of Surgery, 2024) found SADI-S comparable to gastric bypass for weight loss, deficiencies and related conditions, with gastric bypass superior for reflux. Severe complications occurred in 8% after SADI-S and 14% after gastric bypass.
- Seven years after revision for weight regain. A study from Qatar (Salama and colleagues, Surgical Endoscopy, 2026) followed 105 patients: 62 converted to gastric bypass and 43 to SADI-S. Total weight loss at 7 years was 19.59% after SADI-S and 13.23% after gastric bypass. Reflux resolved in 95% after gastric bypass and 5% after SADI-S. Calcium, zinc, folate and vitamin D were lower after SADI-S, and vitamin B12 lower after gastric bypass.
- In a randomised trial. The SADISLEEVE trial (The Lancet, 2025) of SADI-S against gastric bypass included 79 patients (21%) with a previous sleeve. Its results are on our SADI-S page.
Risks
Revision is more complex than a first operation, because tissue has already been operated on.
- Surgical risks: bleeding, infection, leaks, blood clots and anaesthesia risks, higher than after a first operation.
- After conversion to gastric bypass: ulcers at the new connection (more likely with smoking or anti-inflammatory painkillers), internal hernia, dumping symptoms, and low iron, vitamin B12 and calcium.
- After SADI-S or duodenal switch: looser and more frequent stools, and deficiencies of protein, the fat-soluble vitamins A, D, E and K, and minerals. Reflux may continue.
- After re-sleeve: a further staple line, and reflux that can start or worsen.
Planning your trip from abroad
- Send your sleeve operation notes, weight history and symptoms on WhatsApp, with any endoscopy reports.
- Video consultation with a member of the clinic's bariatric surgical team, including whether endoscopic revision or medication may be enough.
- Written quotation for the agreed plan, before any deposit.
- Follow-up from home, with supplements, blood tests and dietitian support.
Sources
- Vosburg RW, et al. American Society for Metabolic and Bariatric Surgery statement on the treatment options for patients with non-response and weight recurrence after metabolic and bariatric surgery. Surgery for Obesity and Related Diseases. 2026;22(7):699-706.
- Matar R, et al. Indications and outcomes of conversion of sleeve gastrectomy to Roux-en-Y gastric bypass: a systematic review and a meta-analysis. Obesity Surgery. 2021;31(9):3936-3946.
- Benamran D, et al. Results of sleeve gastrectomy conversion to Roux-en-Y gastric bypass on gastroesophageal reflux disease symptoms and proton pump inhibitors use evolution over time. Journal of Gastrointestinal Surgery. 2024;28(9):1412-1419.
- Thomopoulos T, Mantziari S, Joliat G-R. Long-term results of Roux-en-Y gastric bypass (RYGB) versus single anastomosis duodeno-ileal bypass (SADI) as revisional procedures after failed sleeve gastrectomy: a systematic literature review and pooled analysis. Langenbeck's Archives of Surgery. 2024;409(1):354.
- Salama AF, et al. Comparative seven year outcomes of RYGB and SADI-S as revisional procedures for weight recurrence regain after sleeve gastrectomy: weight loss trajectory, reflux control, and metabolic safety. Surgical Endoscopy. 2026;40(5):4326-4335.
- Robert M, et al. Efficacy and safety of single-anastomosis duodeno-ileal bypass with sleeve gastrectomy versus Roux-en-Y gastric bypass in France (SADISLEEVE). The Lancet. 2025;406:846-859.01070-0)
Frequently asked questions
How much does revision of a sleeve gastrectomy cost in Thailand?
Contact us for a written quotation, confirmed before any deposit. For reference, a first-time gastric bypass starts from THB 449,000 and Redo ESG from THB 490,000 at YOUNIFY Clinic.
Which revision is used for reflux after a gastric sleeve?
Usually conversion to gastric bypass, which keeps acid and bile away from the oesophagus. In one series, 70% had complete resolution of reflux symptoms.
Which revision is used for weight regain after a sleeve?
Usually SADI-S or gastric bypass. In comparative studies, SADI-S led to more weight loss and gastric bypass was much better for reflux.
Can my sleeve be converted to SADI-S?
Often, yes; the bypass is added to your sleeve. See SADI-S surgery.
What is a re-sleeve?
A repeat sleeve that narrows a widened sleeve or removes stomach left at the upper end. It suits selected anatomy only.
Can a sleeve be revised without surgery?
Sometimes. A widened sleeve can be narrowed from the inside through the mouth. See Redo ESG and endoscopic revision.
Is revision riskier than my first operation?
Yes. In one meta-analysis, 16.4% had complications within 30 days of conversion to gastric bypass.
My sleeve was done at another hospital. Can I still have a revision here?
Yes. Send whatever records you have; the assessment shows what has changed.
How do I start?
Send your sleeve operation notes, weight history and symptoms on WhatsApp. A member of the clinic's bariatric surgical team reviews them with you by video before any travel is planned.
YOUNIFY Clinic · 2nd Floor, Room 214, United Center Building, 323 Silom Road, Silom, Bang Rak, Bangkok 10500, Thailand · Near BTS Sala Daeng (5-min walk) · Open daily 11:00–20:00
WhatsApp +66 81 556 9696 · LINE @younifyclinic · Instagram @younifyclinicthailand · info [at] younifyclinic.com
Medically reviewed by Dr. Noppachai Siranart · Last reviewed
Individual results may vary. Please consult a doctor before treatment.