Revised to BPD?
Hi,
This is Dr. Schlesinger. I hope to be able to clear up any confusion. Let's define some things so that we are all speaking the same language.
BPD: In this operation the surgeon creates a small gastic pouch. The lower portion, the vast majority of the stomach is removed. The intestines are then cut and reconnected in the same way as any Roux-en-Y. BPD has become synonymous with a highly malabsorptive procedure. As it was first described, the common conduit (Intestine having both food and digestive juices) measured 50 cm. Subsequently there have been variations that have had common conduits as long as 100 cm.
Extended Rny (ERny): This is a classic Roux-en-Y Gastric By-Pass with a short common conduit (50 to 100 cm). Like the BPD or DS this is a highly malabsorptive procedure.
In summary, the difference between a BPD and an ERny is that in the BPD the excluded stomach is removed. BPD may also have a larger pouch, but for the purpose of understanding these operations let's not focus on this aspect.
I assume that your initial operation was an Rny (proximal with minimal small intestine by-passed or distal in which more intestine was by-passed. Neither of these operations are highly malabsorptive). If your surgeon is not removing your excluded stomach, then the operation he/she is planning to perform is an ERny.
I perform the ERny for selected patients who have had an Rny and have had a significant weight regain or have fallen significantly short of success. As in all revisions, it is vital to determine what changes are required for success. This is a highly individualized process. The ERny is an excellent operation for the appropriately selected patient. My patients and I are extremely pleased with the results. Remeber that the after care for an ERny is like that of a DS. Close long term follow-up and careful monitoring are essential.
You've likely seen postings in this forum from Joyce. She is a patient of mine and I am confident that she will be willing to share her experience with you.
I applaud you for asking questions, seeking reliable information, and making use of this excellent web site. Good luck to you. Stay positive. NEVER give up!
Eric Schlesinger, MD, FACS
AZ Weight Loss Solutions