BPD Revision? cross posted
Hi everyone. I just went to a surgeon (that I saw once last year) for my 5th year check up. I had RNY surgery 2/4/2002 and lost 100 lbs. but have gained back about 35. I never got anywhere near my goal. Previously my PCP had ordered my blood work and took care of me because after one year out, my insurance no longer covered my original surgeon. Last year I decided to see a new surgeon because I felt I needed someone experienced in bariatrics. We touched a little on the subject of revision then. Today we talked about it a lot. He wants to do the BPD unless there is something wrong with my stomach, etc. He thinks it's too risky to mess with my pouch unless there is a reason to. Wednesday I'm having an upper GI series to check things. I am so confused right now. I thought the BPD was more of an antiquated type of surgery. Does anyone do these anymore without the DS? I would appreciate any feedback on this.
This is not an uncommon way to revise a RNY. Your surgeon will remove the old stomach completely and leave you with the same pouch you have now with the RNY, and connect your intestines further down the line to reduce the lenght of the channel where your food and gastric juices mix for digestion, making it more difficult to absorb fats and carbs.
To change the pouch, and make it a true DS with BPD , it would entail reconnecting a portion of your stomach that was cut away from the part used for your pouch. Then you would need more removed from the old stomach portion to make the new long thin stomach and reconnecting the valve at the bottom of your stomach and completely removing all unused parts of the stomach from your body. It would also mean disconnecting the stoma from the small intestines and then reconnecting the small intestines to the valve. This is very complicated, and is more risky then the surgery DS or RNY in the first place.
As your surgeon plans, you won't have a valve to stop food from entering your intestines too fast, but with a small stoma, the food won't enter that fast anyway. If you have severe dumping syndrome, you may want to ask for the complete revision to DS with BPD. If not, you will probably do great with what your surgeons plans. You will be able to eat a bit more than the RNY, with less absorption of calories. You will need vitamins for life and lab work on a regular basis just as with any DS or RNY.
I wish you great luck with your weight loss.
I had the same revision your doctor is describing. I had a duodenal switch but my gastric pouch was left alone. My remanent stomach was not removed. Your surgeon is correct that reconstructing or any surgical intervention on your pouch is a higher risk procedure. I did not want to take that risk. However, I am losing slowly, 47lbs in 6 months with 48lbs left to go. (Down 72lbs from my highest) I would based whether to have surgery on my pouch on this...how much can you eat? If your pouch has stretched alot and your stoma wide open, you may benefit from a total revision. However, your surgeon knows you and your surgical risks better than I ever could. I can eat alot and have to be careful. I have to exercise alo****ch carbs, consciously eat less that I can fit in, limit how often I eat in a day. I still suffer food cravings, hunger in the morning. Yet with the DS I can eat fat now and this brings a feeling of saiety that helps alot. By the way, I healed very fast as my incision was not very long--didn't reach up to my stomach. I could eat lots of protein from the very beginning. Although I am losing slowly, nothing says I won't lose all I need to and my health has been great during this losing phase.
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