Gastric Sleeve Revision

What Is the SIS Procedure?

30-45 min
Hospital Stay
Time Off Work
1-3 days

Some patients experience weight regain, inadequate weight loss, or the return of obesity-related health problems after undergoing bariatric gastric sleeve surgery. The Sleeve-in-Sleeve (SIS) procedure, developed within the past five years, is one of the most recent and advanced gastric sleeve revision techniques that can be used for patients who regained significant weight after having weight loss surgery.

Gastric sleeve revision - SIS procedure

How Does SIS Gastric Sleeve Revision Work?

Sleeve-in-sleeve endoscopic revision creates a new, smaller sleeve within the existing sleeve gastrectomy to restore the restrictive nature of the original gastric sleeve. This procedure can be performed using various endoscopic techniques, such as endoscopic suturing or plication, depending on the patient’s anatomy and specific needs, which will once again restrict the stomach’s capacity, limiting the patient’s food intake.

Who Is a Good Candidate For A Gastric Sleeve Revision?

The sleeve-in-sleeve endoscopic revision procedure may be suitable for certain patients who have previously undergone a sleeve gastrectomy (vertical sleeve gastrectomy, or VSG) as their initial bariatric surgery and are experiencing weight regain, inadequate weight loss, or the return of obesity-related health problems. Unlike bariatric surgery, there is no firm BMI requirement for an endoscopic revision of a gastric sleeve, and each case will be evaluated individually by the doctor.

Good candidates for the endoscopic sleeve-in-sleeve procedure typically meet the following criteria:

  • The patient has a history of sleeve gastrectomy
  • The patient is experiencing weight gain or inadequate weight loss after their initial sleeve gastrectomy. This may be due to stretching of the stomach pouch or dilation of the sleeve over time
  • Candidates should be in good overall health with no significant medical conditions that would increase the risk of complications during the revision procedure
  • Candidates should be committed to making the necessary lifestyle changes, including healthy eating habits and regular physical activity, to achieve and maintain long-term weight loss after the revision procedure
  • Candidates should have tried conservative measures, such as diet and exercise, but have not been successful in achieving their weight loss goals or managing obesity-related health problems
  • Candidates who have realistic expectations regarding the outcome of the revision procedure

What Are the Benefits?

  • Minimally invasive procedure
  • No incisions
  • Performed as an outpatient procedure
  • Enhanced weight loss
  • Improved metabolic health
  • Reduced risk of complications
  • Potentially reversible
  • Offers a shorter recovery time

What Can I Expect From The Procedure?

While the patient is under anesthesia, an expert endoscopist inserts the endoscope through the patient’s esophagus and into the current gastric sleeve. The stomach is then manipulated to form a smaller sleeve that is then held in place with stitches using a combination of special endoscopic tools.

A gastric sleeve revision procedure is typically completed in less than an hour, does not require any external incisions, and will leave no visible scars.

When the procedure is complete, the endoscope is removed, and patients remain under observation for a few hours before being released to return home to recover.

What Is The Pre-procedure Preparation For A Revision Of Gastric Sleeve Surgery?

Your doctor will provide any instructions necessary in advance of your procedure to help you prepare. Patients must adhere to a liquid diet for 24 hours before the procedure and have nothing to eat or drink for 8 hours before the procedure. The “nothing after midnight” rule applies the night before your procedure.

What Is The Weight Loss Potential After Revision Of Gastric Sleeve Surgery?

The weight loss potential after undergoing a sleeve-in-sleeve endoscopic revision to a gastric sleeve gastrectomy can vary depending on several factors, including the individual patient’s starting weight, overall health, commitment to lifestyle changes, and adherence to post-operative instructions.

However, studies and clinical experience have shown that the sleeve-in-sleeve endoscopic revision procedure can lead to the loss of 7–17% of the patient’s total body weight in one year and also yield significant improvements in their metabolic health.

What Are the Risks & Side Effects?

SIS requires no surgery and the most common side effects last only for a few days. Typical symptoms after the procedure include abdominal cramping, nausea, bloating, and constipation. Your doctor will provide prescription medication to help alleviate these symptoms. The side effects of the SIS procedure usually last for about 3 to 5 days. Given the low caloric intake, some patients may experience fatigue for 1-2 weeks after the procedure, but you can return to work in 3 to 5 days. Major complications are rare.

What Can I Expect During Recovery?

Because the procedure is non-surgical and there are no incisions, the risk of infection or complications is significantly reduced, making for a smooth recovery for the majority of patients.

Most patients are back to their normal schedules after only a few days, with the exception of a special diet they need to follow for several weeks. This special diet is necessary so the stomach can become acclimated to its new size and have time to heal. Patients will begin with clear liquids and transition over the next few weeks to work back up to eating solid foods. Patients will be provided with full dietary instructions.

There are mild activity restrictions after a revision procedure, but your doctor will provide specific instructions unique to your circumstances.

Why Choose Reveal Weight Loss?

Reveal Weight Loss takes great pride and care in being one of the only practices in New Jersey certified to perform the sleeve-in-sleeve procedure.

If you have had a sleeve gastrectomy in the past, the sleeve-in-sleeve procedure offers a non-surgical option to restore the tightness of the sleeve to its original post-surgery size. This endoscopic revision of a sleeve gastrectomy surgery effectively restores the sleeve’s original shape, which helps to reinitiate weight loss without the need to undergo another surgical procedure.

The experts at Reveal Weight Loss have extensive experience in performing this endoscopic procedure and can deliver safe and effective results to get your weight loss journey back on track.

Financing Options

We participate in special financing plans with United Credit, CareCredit, and Cherry to make this procedure affordable for you. Our representative will be happy to discuss payment options that are right for you. Please call us at (973) 629-7534 or email us at Click the link below to determine if you qualify for financing options.

Frequently Asked Questions

Will Endoscopic Revision Help Me Lose More Weight Than My Initial Gastric Sleeve Surgery?

The sleeve-in-sleeve endoscopic revision procedure is designed to promote weight loss; however, the amount of weight loss may vary depending on various factors, including diet, exercise, and individual response. Most patients lose an average of around 7 to 17 % of their total body weight within 6 to 12 months of their revision.

How Long Do The Results Of The SIS Revision Typically Last?

The long-term results of the sleeve-in-sleeve endoscopic revision procedure can be influenced by numerous conditions, such as behavioral changes, diet, exercise, and maintaining a healthy lifestyle.

What Dietary And Lifestyle Changes Will I Need To Make After The SIS Procedure?

In the short term, you will need to follow specific dietary guidelines to allow your stomach to heal after the procedure. Your doctor will provide specific recommendations based on your individual needs. After this initial transition diet, it will be critical for you to make healthy food choices and continue to pursue activities and lifestyle choices that promote weight loss so you can maintain your results.

What If Another Surgeon Performed My Primary Bariatric Surgery?

If you are seeking an endoscopic revision to bariatric gastric sleeve surgery that was done by another doctor, you are not alone. Most bariatric surgeons are not expert endoscopists, and most do not perform endoscopic weight loss procedures. It is important that you choose an endoscopist who is expertly trained in performing the SIS procedure to ensure safe and optimal results. Dr. Sarkar and Dr. Shahid at Reveal Weight Loss are expert advanced endoscopists who have extensive training in endoscopic bariatric procedures.

Where Can I Get A Revision To My Gastric Sleeve In New Jersey?

If you are looking for help addressing weight regain after having a gastric sleeve, Reveal Weight Loss in Livingston, New Jersey, is a premier provider of the much sought-after sleeve-in-sleeve procedure. Set up a consultation with us today to learn more about SIS revision to gastric sleeve surgery and how it may benefit you.

Price Checker
Get A Quote For Your Weight Loss Procedure