Sleeve revision, also known as a re‑sleeve, is a revisional bariatric procedure performed for patients whose original sleeve has stretched or dilated over time, leading to weight regain, inadequate weight loss, or increased hunger. The procedure reshapes and tightens the stomach to restore restriction and improve long-term weight‑loss outcomes.

The existing sleeve is evaluated for dilation, twisting, or anatomical changes. The dilated portion of the stomach is removed, and the sleeve is reshaped into a narrower, more restrictive tube. This restores restriction, reduces hunger, and improves satiety.

Benefits include restored restriction, reduced hunger, improved portion control, enhanced satiety, and renewed weight‑loss momentum. Re‑sleeve is less invasive than conversion to bypass or SADI‑S and preserves normal anatomy.

Candidates include patients with sleeve dilation, weight regain, inadequate weight loss, increased hunger, or functional sleeve issues such as twisting or poor emptying. Imaging or endoscopy often confirms dilation.

The procedure is performed laparoscopically. The sleeve is inspected, and dilated areas are removed. The stomach is reshaped into a narrow, uniform tube. Most patients go home the same day or the next morning.

Risks include bleeding, leak, stricture, reflux, and weight regain if long-term habits are not maintained. Re‑sleeve is less metabolically powerful than bypass or SADI‑S, so patient selection is important.

Days 1–3: hydration, ambulation, pain control. Week 1: liquids. Week 2: soft foods. Weeks 3–4: gradual return to normal routines. By 30 days: improved satiety and reduced hunger.

Patients typically experience renewed weight loss and improved hunger control. Results depend on anatomy, adherence, and metabolic factors. Re‑sleeve is most effective when dilation is the primary cause of weight regain.

Dr. Nestor de la Cruz‑Muñoz is a nationally recognized bariatric and metabolic surgeon with extensive experience in revisional sleeve surgery. His expertise ensures precise sleeve reshaping and safe outcomes.

Most patients lose 10–18% of total body weight (TBWL) over 6–12 months after re‑sleeve. Results depend on anatomy, adherence, and metabolic factors.

Re‑sleeve improves satiety and portion control but has limited metabolic impact compared to bypass or SADI‑S. Patients with metabolic disease may benefit more from conversion procedures.

Long-term success requires protein-forward nutrition, resistance training, avoiding slider foods, maintaining muscle mass, and consistent metabolic follow-up. Body composition monitoring is essential.

Re‑sleeve may worsen reflux in some patients. Patients with severe GERD may benefit more from conversion to gastric bypass.

If re‑sleeve is not sufficient or if metabolic disease is present, future options include conversion to gastric bypass, OAGB, SADI‑S, or DS.

Preserving lean mass is essential for long-term success. Patients are guided to prioritize protein intake, resistance training, hydration, and body composition monitoring.

Insurance coverage varies. Documentation of sleeve dilation, weight regain, or functional complications may be required.

Pre-op requirements may include bloodwork, imaging, endoscopy, nutrition consultation, psychological evaluation, and medication adjustments.

Nutrition progresses from clear liquids to full liquids, purees, soft foods, and then regular textures. Protein goals and vitamin supplementation are essential.

Early walking begins immediately after surgery. Light activity continues through week 2. Resistance training typically begins at week 4–6.

Miami is a major hub for patients from Latin America and the Caribbean. Our team supports travel coordination, virtual follow-up, and streamlined pre-op evaluation.