Seeking a Revision from Lapband to RNY

I had lapband surgery 1/23/06. I started at 5' tall and 297 pounds.I am 59 years old and my metabolism must be slowing down as well. I still am 5' tall but have gotten down to 211 at my lowest weight. For the past few months I have put on and taken off the same 5 pounds many times. This means that my BMI is still over 40.  I have followed all of the rules my doctor has given me. I have worked hard at the band but I have just stopped losing. Both my surgeon and my PCP feel that my band has done all it is going to do for me and that I need to add malobsorbtion(sp) in order to start losing again. I have started making clearance appointments for RNY. Also in the last week I have started getting acid reflux. I have not had a recent fill and do not think that I am too tight.I have 9cc in a VG band. With the acid reflux I do not think I can risk another fill. I still have type 2 diabetes and high blood pressure although both are better than before the lapband. I would appreciate any advice.

Hi Marcia, I haven't seen you in a long while.  How is your husband doing? You should try to come to the next Good Sam support group meeting, it is not this Saturday, but next from 9:00-10:30.  There are a few people who have had revision from lap band to RNY. They've all been extremely successful with it.   And Jane from this forum also goes, I'm sure she'll be more than happy to chat with you about it.   Best of luck to you....have you been attending Dawn's group?  I haven't gotten any info from her in a very long time. Keep in touch!

Hi Maryellen, It's so good to hear from you! I will be coming to one of the next meetings at Good Sam. I will try to make it the next one. My husband has done great with the RNY. He has lost 150 pounds and is at goal. I just want to follow in his footsteps.

Hi, it sounds like the Lapband has done what it was intended to do (you were ~ 197# overwt, and lost 86# or ~ 44% of excess). The band's early pamphlet stated 33% excess loss expected/typical. You have exceeded that. But if you deisre more wt loss then considering a revision may be in order. Note that revision operations are more technically challenging and carry a higher complication risk. Consider strongly seeking out a very experienced bariatric surgeons that performs many revision surgeries. Not everyone *****gains weight or fails to lose as much weight as they would have liked are candidates for revisional surgery. Because morbid obesity is a multi-factorial disease, a multi-disciplined approach should be utilized to treat patients that have regained or failed to lose weight. No surgey is meant to give a 100% excess wt loss, but they are helpful to lose significant wt and maintain! No diet can give a 44% wt loss over 5 yrs! RNY is a logical choice,sometimes though the second time around the body has adapted and many do not lose as much as thy thought they would. Go to the revision forum and sites to those who are 3-4 or more yrs out of revision to see what is typical, for a most educated and informed view!

ALso consider many rnyers are getting revised with bands over bypasses, stomaphyxes and some go to ultimately a 2nd or 3rd surgery like BPD/DS..Please consider the BPD/DS in your choices!!! There is little malabsorption with a proximal RNY! It is mostly in first 6 months and the darn small intestines do adapt around that!!! Just my 2 cents on being 5+ yrs out and seing the issues we have and paths many go for revisions!!!

You have about 111# to lose a RNY may help you lose/maintain another 50# give or take of that, a BPD/DS may help you lose closer to 80-90# of that!!!

I'd also get the reflux looked into now, dont let that sit as it can do damage to the esophagus and cause issues for revision etc..this is not a expected outcome! HUGS


2 articles FYI
http://www.bariatrictimes.com/displayArticle.cfm?articleID=article207
Revisional Surgery Article:
Bariatric Revisional Surgery
- by Rodrigo Gonzalez, MD; Scott F. Gallagher, MD; and Michel M. Murr, MD, FACS

EVALUATION FOR WEIGHT LOSS FAILURE
http://home.comcast.net/~muzicluvr777/Eval.htm


This is a great group http://groups.yahoo.com/group/WLSrevisionsupport/ of people who can definitely lead u in the right direction!
I also know OH has a different Revision Forum.
http://www.obesityhelp.com/forums/revision/

Dr. Garbers link on revisions (note someof the info on revision difficulty and increased complications came from this link!)
http://www.stopobesityforlife.com/revision.html

Be well and keep in touch!

Thanks very much!

Jamie, Is the projection of weight loss 33% after surgery or does it include from the start of medifast. I lost 28 before surgery (10%) and 12 lb. since surgery on the band. I had surgery 5 weeks ago this Wed. the 26th. I feel like the weight is really slow coming off but maybe not. I can tolerate many things but tend to still eat too fast. I believe I will most likely get a fill this Friday at my 6 week visit. I don't feel that I eat too much but I have been eating more than a 1/2 cup of food at a time. I can handle more before feeling full. Is that normal at this point. It may seem like more because of mashed potatoes and soft foods going down easily or can we eat more when it is soft like potatoes and pudding etc. Thanks, Nancy

send me your email i will forward the pdf file it is with the surgery..remember banded pts tend to lose slowely over time; many do not lose until a fill even unless strict diet intake and exercise is employed..slider foods will always go thru, fill up on protein! it is heavier! Keeps u full longer band or bypass!

the stat actually state 36-38% yrs 2 and 3 this was from 2002/2003..some lost 100% and some gained...individual results vary! that is why I said 'original stats', they are showing higher EWL now..55% +/-; comparable to some bypassers at 3-5 yrs who tend to lose more in yrs 1-2 but regain.
this is ecxcellent site to check and read! Sign up for the free enwsletter. The band will work as well for you as you do with it! So enjoy the rebirth and journey called life! http://www.lapband.com/lapband/portal.do

thanks Jamie, my email is [email protected] see you on the 7th

Hi Marcia, I was revised from band to RNY.  I am currently 6 lbs. away from my goal weight, which according to the table in this site somewhere, is 100% of my excess weight lost.  I know I will have to work hard to keep it off, RNY is not the magic cure I thought it would be.   Had I known about the DS at my time of revision, I might have pursued it, but I am still absolutely thrilled to be where I am today.  Dr. Garber is very experienced in revision from band to RNY. Have you had your band checked for slippage, erosion, or other problems?  You are NOT supposed to have reflux w/the band, and your not getting a tighter fill is a VERY smart decision on your part.   Feel free to PM me, and I look forward to your posts. take care,

thanks very much for your support!