I have an idea WHY Stomaphyx works for some and not others

Hi everyone, I have an idea, just a theory, about why stomphyx works for some and not for others.  With this procedure, the doctor makes you pouch smaller, but doesn't touch the stoma.  I believe if a person's stoma is large, food will continue to pass too quickly, even if the pouch is made smaller. So if the patient's pouch is large and the stoma is average, then the stomaphyx will reduce the pouch size and since the stoma is average, food will not pass too quickly and those patients will lose the most weight. I'd love to hear from those of you who've had the stomaphyx procedure - let me know if I'm right or not. I'm waiting for my insurance to approve a revision, and really need to know what works and what doesn't. Thanks Nan C 

Well,  the part about not touching the stoma is not true.  They can pleat the pouch ( I believe more than one row if necessary) and can pleat the stoma as well.  But your idea about food passing right through is correct.  Good thoughts though!

Tina01 The surgeon who did my original WLS is one of the only two surgeons in NY doing the stomaphyx. When I had my consutation with him about the stomaphyx, he is the person who told me that the pleats are put in the pouch, not the stoma. He told me that in the near future there will be a procedure expressly for enlarged stomas. When he told me this I thought the name was a bit odd - stoma-phyx, which I thought should mean to fix the stoma. Perhaps there are surgeons out there who are making the stoma smaller, but not my surgeon. I tried looking it up on-line to see what the protocol for stomaphyx is, and there isn't enough information, by the manufacturer, listed. Nan

Stomaphyx definely shrinks the stoma.  (I'm just guessing that's where they got the catchy name "stoma fix")   In addition to pleating the stoma, the surgeon also pleats the stomache in 2 or 3 rows to reduce that volume as well. But the stomaphyx is a fairly mild revision (and I'm guessing that it will have milder results too).   Personally I'm just hoping that my stomaphyx will last for 35 - 50 pounds of weight loss!

I may get flamed for this but I have to ask it anyway.  My problem with the StomaFX is this:  It enlarged once.  What is to say it won't enlarge again? 

 

That was my problem with having my RNY fixed......as many of you know, I chose the DS revision from my RNY. Even though it was more difficult to find an experienced surgeon.  Even though it's the most difficult, complex surgery of them all with greater chances for problems.  Even though it cost me more money OOP.  I just didn't want to chance that a 2nd surgery would eventually fail me and then I'd either be looking at a lifetime of obesity (too old, too dangerous, etc) or periods of time that I would be miserable and needing to chance that 3rd surgery. 

I just didn't want to go there. 

Having a failed WLS is depressing and makes us want to blame ourselves but in all too many cases there are reasons of mechanical failure that make it impossible to keep the weight off.

Yes the DS is more malapsorptive although I will say the trade off of no fear of regain and taking my supplements for life (as do any of the malapsorptive surgeries) are a small price to pay for the wonderful gift I've received. 

Hi Dawn- I agree with you about the stoma possibly stretching again (after full revision or stomaphyx).   Any time we abuse our pouches their is always that risk.   I had my stomaphyx last Thursday.    But here's the thing.  I only have 35 pounds to lose.  There is no way in the world I would even consider major surgery for only 35 pounds.  And certainly my insurance company wouldn't pay.   My BMI isn't high enough.   But, for me, those 35 pounds are VERY difficult to lose without assistance.    And that's where the Stomaphyx was perfect for me.   Minimally invasive, little down time (I could have returned to work the next day without issue) and relatively low cost; options like stomaphyx are perfect for lots of people like myself.  Additionally, I personally don't want any more malasorption....I'm very happy with the foods I can eat....I just want to be less hungry as I take control of my diet. I'm glad that YOU made the right choice for YOU.   And I made the right choice for me.   Everyone must decide what works best for them.   And we are very fortunate to have such good choices to assist us in ALL OUR GOALS of losing weight and maintaining a healthier lifestyle. Lorri

You have hit on something about every restrictive WLS procedure there is. There is always a chance of stretching. Even the vertical sleeve gastrectomy stretches, although theoretically less than the RNY pouch. A DS doctor at our Ds support group said the restrictive portion helps take the weight off, and the malabsorption keeps it off. I am thrilled to have the stomaphyx working so far and have the DS of a 75cm common channel to fall back on to maintain my loss. You chose a procedure with a high complication rate and if your insurance covered it you are one lucky gal. I am so glad you are happy with your decision and it has worked so wonderfully for you. Many of us are happy there are different options available, as we have different tolerances for risk, insurance considerations, and different anatomical considerations. I am so relieved my insurance is now covering my follow up care after the DS-like revision. I wish I had chosen a DS at first, but that was not an option for me 15 years ago and I am thrilled my daughter got a WLS that seems better suited to her needs than the RNY and lapband. She has learned from my experience so it was not totally wasted.

I have to eat like an RNYer now, but I accept that as the consequences of my decisions in the past and hope I am more educated about how to not stretch my pouch. I seriously had no support and little education 15 years ago. I would recommend to anyone who has an RNY or other WLS and needs a revision for major weight regain to get a full DS. I hope my experience lets people know that the restrictive portion is also important in the revision world. I needed both the restriction and malabsorbtion. I believe sharing our experiences helps others make a decision that is right for them based on their individual needs.

Well, I can only comment about my phyX.   Eleven yrs ago, my original surgeon made a huge pouch.  I had no restriction, and at 6 mos post op, I was requested a revision  ... I was not losing weight.   I pressed hard, and 12 mos later, the surgeon performed a revision that bypassed nearly ALL of my small intestine.  He refused the reduce my pouch size.   It was every bit as 'radical' as the famed DS.  I did lose all my weight, despite *large* volume eating.  Long story short... My operative notes for the StomaphyX state that my original pouch was very large & long.   Dr. Overcash could not reach all of my pouch with the tool.   He put in 25 clips in the areas he could reach.     Prior to SP, I spoke with surgeons about getting my pouch fixed.  I thought the SP could do it.  Wrong.   Most of the people getting SP do not have enough exra weight to qualify for  a revision... this is where SP comes in.  You have to have at least a 35 BMI to qualify.  My BMI was 32.  Also, I have so much adhesion from two open cuts that no one wants to go near my intestine.   (I HIGHLY recommend a lap procedure when possible).   However, my story shows 1) that a very distal bypass willl work with or with out the 'switch'; and 2) That original pouch size and shape matters.   Amy

Hi Amy, It's good to hear from you again.  I'd like to hear more about how you've been since SP.  We are all coming at this from different experiences.  I have mySP tomorrow.  I've done a lot of homework on this and it really does come down to the individual.  I do have a higher BMI, but I'm also able to accept that I won't lose 75lbs from this.  I'm looking for 40-50 though.  I do not have a large pouch, but I do have an enlarged stoma.  My surgeon will only make the stoma smaller for me, but it may make my pouch a bit smaller because of the pleats.  Personally, I'm in a place in my life where I could qualify for a DS or more drastic bypass that would inevitable be more "successful", but I don't want the risk and consequences at this point.  I have two small children at home and I haven't weighed under 200 lbs since about the 4th grade.  I will never be a size 4 or even a size 8.  But I will be healthy.  I want to eat healthy and show my girls a healthy relationship to food.  I love to eat and sometimes it sounds nice to have a more distal bypass or DS so I could enjoy all the foods in mass quanitity.  But, I don't want my girls to see that or to need surgery one day. So, bottom line is we can't assume one thing is better or more successful for everyone.  Stomaphyx is in no way a big miracle cure to regain, but it can help to have a "tool".  If 5-10 years from now I am struggling, DS is still an option.  That's the one thing I do like about the SP procedure - it's relatively low risk. I hope everyone finds the solution that is right for them.  The most important thing to do is to learn as much as you can before making a choice. ~Shelley

Amy, I had a RNY with a slightly larger pouch, and a 200cm common channel, meaning almost all of my small intestine is bypassed. While I am grateful for the extra malabsorption, my surgeon said anyone can regain weight if they don't learn new eating habits and control their portions. I just wanted to mention that you aren't alone with an unusual weight loss surgery. I just hope i don;t have any regain, and I'm trying to make sure by following all the rules.

Good luck to you.