- Most common: band to bypass, sleeve to SADI or bypass (Vitalys).
- Reasons: reflux, vomiting, too little loss or regain.
- Always a new screening first.
- Higher risk than a first operation.
- Usually covered with a medical reason.
What is revision bariatric surgery?
A revision changes or replaces an earlier bariatric operation. Vitalys names converting a gastric band to a gastric bypass and converting a sleeve to a SADI or bypass as the most performed redo operations. When someone cannot maintain their weight after a bypass, Vitalys sometimes places a MiniMizer ring or lengthens the bypass.
The Catharina Hospital often removes gastric bands in order to create a bypass later. The Flevoziekenhuis describes that removing a band and creating a bypass can usually be done in one operation, but sometimes in two steps when the stomach needs time to recover.
Why a new screening is always needed
For a redo you are screened again. Depending on what you went through the first time, that can be a short individual pathway or a full pre- and post-operative programme. The team wants to understand why the first operation did not work as hoped, because a second operation only helps if the underlying cause is addressed.
When is revision surgery considered?
Typical reasons are persistent reflux after a sleeve, frequent vomiting or slippage with a gastric band, insufficient weight loss or significant regain, and complications such as a narrowing or ulcer that do not respond to other treatment.
A second operation carries a higher risk than the first, because of scar tissue and adhesions. It is therefore a careful, individual decision, not a quick fix for a few regained kilos.
Advantages and points of attention: revision surgery
Advantages
| Advantage | Explanation |
|---|---|
| Solves complications | for example reflux after a sleeve |
| Renewed weight loss | e.g. SADI after a sleeve |
| Band problems solved | conversion to bypass |
| Covered | with a medical reason |
Points of attention
| Point of attention | Explanation |
|---|---|
| Higher risk | scar tissue and adhesions |
| New screening | extra time before surgery |
| Sometimes two steps | for band conversion |
| Underlying cause | eating habits must be addressed too |
Cost and insurance (2026)
With a medical reason, revision surgery is usually covered by the Dutch basic package.
| Item | Amount or arrangement |
|---|---|
| Revision with medical reason | €385 deductible (2026) |
| Revision without indication, self-pay | price on request per clinic |
| Vitamins after conversion | about €10-€15 a month |
Revision surgery: key figures
| Feature | Value |
|---|---|
| Most common revisions | band to bypass; sleeve to SADI or bypass |
| Band conversion | usually one operation, sometimes two |
| Screening | always repeated |
| Risk | higher than a first operation |
| Coverage | basic package with medical reason |
Common revisions at a glance
| From | To | Typical reason |
|---|---|---|
| Gastric band | Gastric bypass | vomiting, reflux, regain |
| Gastric sleeve | Gastric bypass | persistent reflux |
| Gastric sleeve | SADI | too little loss or regain |
| Gastric bypass | MiniMizer ring or longer bypass | regain (Vitalys) |
Step by step
- Symptoms or regain. Discuss with your GP or centre.
- Referral. To a DATO-certified centre.
- New screening. Short or full pathway.
- Surgery. One or two steps.
- Aftercare. Follow-up adapted to the new procedure.
Read next
- Gastric band problems — and removal
- SADI after a sleeve — second step
- Gastric bypass as revision — the usual target
- Cost and insurance — coverage
How to prepare for a revision
Bring the operation report of your first procedure, a history of your weight since then and a list of complaints. If the first operation took place abroad, request the report and have it translated into Dutch or English; without it the team cannot plan a revision safely.
Be honest about eating habits since the first operation. Grazing, liquid calories and eating without hunger undermine every procedure, including a second one. Centres combine revision with dietary and psychological guidance for exactly that reason, and a revision only makes sense when the underlying cause is addressed as well.
Revision after surgery abroad
Vitalys sees more and more patients who seek help after an operation abroad. If you had surgery outside the Netherlands and develop problems, ask your GP for a referral to a DATO-certified centre. Coverage for a revision with a medical reason follows the normal Dutch rules, but the centre will want complete information about the first operation.
Expect the screening and planning of a revision to take longer than for a first operation, because the team needs to study the anatomy and the earlier procedure carefully.
Frequently asked questions about revision surgery
According to Vitalys, converting a gastric band to a gastric bypass and converting a sleeve to a SADI or bypass.
With a medical reason it is usually covered by the basic package. You pay your deductible, 385 euros in 2026. Ask your centre to confirm coverage in advance.
Yes. Scar tissue and adhesions make a revision technically harder and increase the risk compared with a first operation.
Yes. It can be a short individual pathway or a full programme, depending on what you went through the first time.
Usually yes, according to the Flevoziekenhuis. Sometimes it is done in two steps, when the stomach first needs to recover.
Vitalys sometimes places a MiniMizer ring or lengthens the bypass. Guidance on eating habits is always part of the approach.
Mainly because of persistent reflux that does not respond to medication, and sometimes because of regain.
To achieve additional weight loss after insufficient results or regain, when reflux is not the main problem.
There is no fixed term; it depends on the reason. A planned two-step approach with a SADI usually takes place about two years after the sleeve.
At a DATO-certified centre with experience in revisions. Ask your GP for a referral and check contracting with your insurer.
Call +31 6 38048347 (Mon–Fri 09:00–17:00) or email info@maagverkleining-info.nl. This page is also available in Dutch.
Sources
- Vitalys (Rijnstate): redo surgery
- Flevoziekenhuis: revision after gastric band
- Catharina Ziekenhuis: bariatric surgery
- DATO Annual Report 2024, DICA
Search terms leading here: revision bariatric surgery Netherlands, redo gastric bypass Netherlands, gastric band to bypass, sleeve to bypass conversion.
Author: Gijs Bodenstaff. Last reviewed: September 2026.