changing mind on surgeon

o****ep going over advice, and suggestions in the end it will be my decision but I  want a revision.  I was thinking of a RNY to DS, but now thinking about going RNY to lap band over it.   I am fearful of the malabsorbtion issues, and I would have to travel to a great surgeon in NYC.   I am now considering Dr. Garber,  NY Bariactrics.  I have been through a RNY and the ROSE procedure.  I have about 50lbs to loose.  thanks to everyone for thier comments and suggestions...michelle 

Hey Michelle,

Dr garber is FABULOUS! I have heard great things about his work. I have also heard he doesn;t take insurance or he only takes very few kinds. I have also heard he has a huuuge ego.... But if that doesnt bother you more power to you!

I have never heard of the ROSE procedure but I am sorry to hear it has failed. Dr. Garber was one of the founders of the Stomaphyx... I know a few people who have had it. Have you heard of it? Its an out patient procedure and no incisions required. That might be omething you can consider as well. Whatever you chose I hope it works for you! Good luck with your decission and keep us posted of your decission and ur progress!

Rachel 

Michelle:
It would be helpful to understand what your issues are with the RNY or regain. What led to it and keeps it an issue? Mechanically have things been explored and is there issues? Was original surgery ever successful for a time? What factors may lifestyle choices effected outcome?

I ask because it is near impossible to advise anyone without understanding these things. When folks have mechanical failure like a enlarged stoma or pouch, or a gastro-gastro-fistula or stapleline disruption these clearly lead on to think about thingslike a ROSE/STOMAPHYX or band over bypass (if even possible it is not always due to adhesions etc). If regain is not due to or totally due to mechanical failure then lifestyle choices woould be a consideration. Tools are helpful but as we all know if not used to help us change our lives to be more active, and decrease or emotional attachment to food no revision will help that. I am not sure your issues or factors at play but I know many times folks look to a revision to fix what it can not (emotional eating, unhealthy fod choices, grazing, night eating, lack of exercise, drinking calories, drinking alcohol, high refined carb diet etc).

Sometimes regain is a little of both. Even RNY to DS can fail (have seen it) when the lifestyle/emotional piece is not attended to. DSers can regain wt and have when they eat lotds of sugar....No matter how much intestines we get bypassed no amount of malabsorbtion can mak up for things like grazing, drinking many calories, sugar etc in those not active, of course this is not everyone.

Many of us get the wrong tool to start, or ours is broke, or we do not realize the enormity of the decision and changes we have to involve on top of the tool. Revisions are much riskier, carry greater higher complication rates, are not always possible (insurnace wont always pay, people can not afford, can not find a surgeon to do it or can not be safely expolred etc)..For 50# that is a good question to ask a surgeon. WLS is not meant to get anyone to an normal BMI, it is meant to get folks to a lower BMI, many remain overweight. RNY to DS is a option for some, individual choice to make with a surgeon who is very familiar with revisions, I recommend Dr. Gagner who is moving back from MIami, he is world renowned in the DS arena and revisionsarea, first to do a LAP DS....

I have an article or 2 on RNY to DS if you want them from obesity medical journal. I wish you well on your journey!

If your issue is no restriction aband may do it, but if it is not can not see how that would help much?

Are you a 100% compliant patient as DS needs dedication to supplements and labs or the outcome malnutrion is potentially more deadly than obeisity it was meaning to treat. DS can be safe in those who fup and treat the nutritional deficiencies....