Help Please!!!

I just recently discovered that I had the fobi pouch procedure instead of the regular RNY. Over the past three months I have had severe issues with eating. My surgeon has attempted to dilate on three different occasions with no success. I am 13 months post-op and can barely eat anything with substance. My diet is limited to protein drinks with a milky consistency, crackers, and mashed potatoes. I have scheduled to remove the ring/band on the 1st of August. What do you guys think? Any feedback/comments would be greatly appreciated.

Do you also have problems with vomitting and or acid reflux?

The difference between a RNY and Fobi pouch is much more complex than just the silastic ring around the stoma.

I had my fobi pouch done on 10/28/09. I had severe dumping syndrome, reactive hypoglycemia, constant nausea, reflux, vomitting, and solid intolerance. I chose to be revised to the duodenal switch, which you can find info in my signature, on 4/11/11, and all these problems have gone away.

Here's the difference between a RNY and fobi pouch:

   A RNY is mad by horizontally cutting about one ounce of the stomach from the lesser curvature of the stomach to crate a bulb shaped, proximal pouch. Then the intestinal bypass is done. The connection between the pouch and small intestine bypass is called the stoma.

One major problem with RNY is that after some years it is quite common for the stoma to dilate, causing food to rapidly empty from the pouch into the small bowel and causing one to be able to eat more. This is associated with regain.

Dr. Fobi thought that if he put a ring around the stoma it would prevent the stoma from stretching. The problem is that the standard bulb shaped RNY pouch does not have enough surface area to place the ring, so fobi has to cut more of the stomach. He does this by cutting into the stomach vertically (you may hear the fobi pouch referred to as a vertical bypass with silastic ring) and therby bypassing more of the stomach than a RNY. Now with more stomach cut he can make a longer, tube-shaped pouch, which he can then fit the silastic ring around the stoma.

I know that's a mouthful, but try to picture it. More stomach cut means more active cells are exposed by the blood supply on the lesser curvature of the stomach. This is why vommiting, solid intolerance and reflux problems are much more frequent in fobi pouch patients than RNY. In my opinion, your dietary complications have little or nothing to do with the ring. It's the way your stomach was bypassed that I assume is causing your problems. This is why I think you should research the revision I had. I think converting your fobi pouch to the uodenal switch would fix your problems. Just removing the ring probably wont change anything, because you will still be stuck with the pouch that is causing your complication.

Thank You for sharing. I have an appointment with the surgeon on Wednesday and will discuss this with him. Did you have the same surgeon both times?

No. Unfortunately there are few surgeons who do the duodenal switch (DS), and even fewer who will revise a fobi pouch to the DS.

The problem with bringing this up with your surgeon is that he does not do the DS, so of course he will not agree with what I have to say. He would lose business if he did. I can tell you that removing the ring will not help, and you should research revision to the DS. Please got to the links in my signature, and I would suggest you post on the DS forum as well.

I would also recommend that you consult with Dr. Keshishian or Dr. Rabkin. They are the two best revision surgeons. They are both here in CA, but they do consults over the phone. Many have traveled for this revision, and it is well worth it, so you can have a surgery that will allow you to eat normally.

My surgeon, Dr. Keshishian can be contacted through his site dssurgery.com. If you email him he usually gets back right away. I'm not sure what Rabkin's site is, but you can find that on the dsfacts website.

Is the Fobi Pouch procedure still used?

please stop eating all carbs...
the protein drinks are also loaded with sugar and carbs.
if you can eat mashed potatoes you can eat baby food.
how much have you lost in 13 months>
Are you exercising?
you look like you have not lost much in your breast area.... they are full of fat.
Further....how could you not know which proceedure you had or will have???
We all need to be responisble... JEESH
I am very curious to know where you had this surgery??? that you did not know that you had?

You really could have kept this comment to yourself...its one thing to show concern but to be degrading and cynical is totally unnecessary. I'm sure the creator of this cite intended for us to be a source of support for one another rather than critics. I am 20 months out, maintaining 150 lbs off...I maintain my diet very well and my fatty breast or lack there of is none of your business! I haven't posted any new pics in a long time, so you really don't know how I look...UGH!

PLEASE NEVER RESPOND TO ANY OF MY POSTS EVER AGAIN...Thanks

I just read your post.  Did you have the ring removed?  I am also a patient of Dr. Burrowes and I'm having difficulties as well.  I had my surgery 11/20/10.  I have lost 130 pounds but I can't eat anything.  I still throw up daily.  I have had mine stretched once but right now I have no insurance so whatever I decide to do it has to work because I'm going to have to pay for it.  At times, I feel like they think it's all in my head but it' not.

Yes, I had the band removed on 8/1/2011 and it was the best decision of my life! I still have RNY, but I don't have that stupid band that I DID NOT ask for. I still can only eat small amounts and I am still 25lbs below my original goal weight.