Important! If you're thinking of a revision..Read this 1st!!!

lori86
on 5/20/08 6:34 am - Bothell, WA

Hello All! I have been reading several posts from people regarding different procedures to revise their original wls. I had my RNY in 2004 without any complications. About 2 yrs later though I started to regain weight. I went back to my surgeon, who has since retired, and he sent me to have an upper endoscopy. It was found that my pouch size was great but my stoma was wide open hense food was going in and straight through. He stated I would need a revision to correct this and of course...it cost more than my original wls. Since my insurance doesn't cover wls I had no resourses to cover a revision...which started me on my search for an alternative option. With success I found a procedure that had been performed on stomas that had been stretched without having to do a full revision. Best part is my insurance covers it. Please read below. This is some of the information I found 2 years ago. I did have this done and it worked great. I did need to have 3 procedures done to have my stoma go back to its original size but there is no pain and/or down time with this.

Department of Surgery, Fletcher Allen Health Care/University of Vermont College of Medicine, Burlington, VT 05403, USA. [email protected]

Title: Treatment of Dilated Gastrojejunostomy with Sclerotherapy

Author(s): Laurie Spaulding MD, FACS

Source: Obesity Surgery Volume: 13 Number: 2 Page: 254 -- 257

DOI: 10.1381/096089203764467162

Publisher: FD Communications Inc.

Abstract: Background: Dilation of the gastrojejunostomy after gastric bypass may result in weight gain. Many surgical and medical treatments have met with poor results. A feasibility study of endoscopic sclerotherapy (ST) of the gastrojejunostomy was performed, based on the known risk of esophageal stricture in the treatment of esophageal varices. Methods: From 1991 to 2001, proximal Roux-en-Y gastric bypass (RYGBP) was performed on 685 patients, with a follow-up rate of 60% at 5 years. 20 patients were identified with dilated gastrojejunostomy (DGJ) by gastroscopy (EGD) performed for complaints of weight gain and marked increase in volume tolerance. Sclerotherapy of the gastrojejunostomy was performed during EGD. EGD was repeated 2 months after the sclerotherapy to measure the diameter of the anastomosis and observe any complications. Weight and sense of satiety were also measured, 2 and 6 months after ST. If necessary, the procedure was repeated to achieve a diameter of 10 mm. Results: Reducing the diameter of the gastrojejunostomy to 9-10 mm was achieved in all patients, with an average of 1.3 treatments per patient. 15 patients (75%) lost weight. The average weight loss was 5.8 kg (ranging from 0.5 to 17.3 kg) in 2 months. Conclusion: Sclerotherapy successfully restores the desired anatomy of gastric bypass, but exercise and dietary discretion remain critical elements of sustained weight loss.

I hope this helps those considering a revision and provides a successful alternative. Many Hugs! Lori

Duval Diva
on 5/20/08 6:55 am - JACKSONVILLE, FL

VBG on 07/05/04

I had this done Friday i hope one is all i need

(deactivated member)
on 5/21/08 3:21 am

Hi Diva- Was your procedure performed with general anesthesia or with something less? Is your post procedure diet typical of other revisions (liquids for a couple of weeks, then soft foods, etc??

ShielaC.
on 5/20/08 10:18 am

Thank you for posting this. I thought Stomaphyz, Rose or Restore were the only procedures that could make the stoma smaller. Insurance won't pay for those yet. I had herd that Sclerotherapy didn't work. Did they go in through your mouth?

Arizonadck
on 5/20/08 10:39 am - Chicago, IL

I never heard of this. I'm very curious about it - and what a great alternative to additional surgery! Is it done with an endoscope? I ask because I tried to have the ROSE (which is done through the mouth) and the tool wouldn't fit in my pouch (too small) to get to my stoma to cinch it. If you would let me know. Thanks so much!

lori86
on 5/20/08 11:47 pm - Bothell, WA

Hi, Yes this is done with an endoscope through the mouth. I know the tool used for the Rose looks a lot larger than I thought it would. The tool used for this is very small. When I had this done my doctor was able to get my stoma back to its orginal size of 9mm. I hope this helps. Feel freel to ask any questions. Lori

Arizonadck
on 5/21/08 12:55 am - Chicago, IL

Were any projections made - how much weight you could expect to lose? With the ROSE, I was told I would lose what I gained but probably not the additional amount I had wanted to lose (before I started gaining). What was the recovery time? Do you feel the restriction? Thanks!!

JROLFSON
on 5/21/08 4:02 am - St. George, UT

Hi Lora: Can you tell us how long ago you have these 3 procedures, where and what your success rate has been, i.e. before procedure weight after procedure weight. I know these seem like invasive questions, but this sounds like a procedure that could be for me....but first I would want to know how much weight one could expect to lose, or how much success others have already had. Thanks so much. JRolfson

lori86
on 5/22/08 2:46 am - Bothell, WA

Hi, This did help me start losing again. At the time I had this done I had completely stalled and even begain gaining. After I had this procedure I lost my last 40 pounds. Right after I was advised to drink liquids for the first 10 days and then begin adding additional foods. For me it was the best thing especially since there is no recovery. You are put to sleep but only for the procedure. As soon as the doctor is done you are immediately woken up. As far as how much one could expect to lose??? It is just like when we first had our wls...it depends on you. If you drink and eat the food will move through quicker leaving you hungry again. If you follow your pouch rules you should lose. I also exercise several times a week. Please feel free to ask any additional questions. Lori :-)

getinther
on 5/22/08 4:16 am - AL

Hi, How do we start the initial process for this type of procedure? I am very interested. Thanks

Important! If you're thinking of a revision..Read this 1st!!!

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Important! If you're thinking of a revision..Read this 1st!!!