Hiatal Hernia Post VSG

I'm actually already 2 years post op VSG. I wi**** had been there or been seen at the actual time of my VSG so that it could have been repaired during surgery. Mine has gotten painful as time had gone by

Hello yes I actually saw a VSG along with a hernia repair at the same time. My understanding is that they try to repair any esophagus/stomach hernias at the same time. I'm going to make sure my surgeon sees if he can fix mine when I go for my VSG next month.

I know it doesn't help much, but what you are going through is fairly common. You aren't alone.

No one likes the idea of having a second surgery. And if it were me, I would get a second opinion before going back on the table.

As you are making decisions keep something in mind. Find out, as best you can, what the chances of success are of doing another surgery without revising to RNY. Will it fix everything? If not, you very well would need yet another surgery. Or revise now, as your surgeon suggested, and be done.

Likewise, I would get a second (and third, possibly) opinion before getting into more surgery. Certainly see what can be done with your GI doc to treat the bile reflux non-surgically before going further. A gastric bypass isn't necessary to correct a hiatal hernia - those are not that uncommon after bariatrics, and it isn't the best approach for bile reflux, either.

On the second opinion front, if possible, see if you can find a semi-local DS surgeon to weigh in on your case - they tend to be the most experienced in the bariatric arena in sleeves and correcting problems with them (though there are some VSG specific specialists out there, too, but they generally come from the DS world - the DS uses the sleeve as its basis, so those guys have been doing them longer than the general bariatric surgeons who mostly have specialized in the bypass and bands until the stand alone sleeve came on the scene a few years ago.) https://www.dsfacts.com/duodenal-switch-surgeons.php has a very incomplete listing of DS surgeons as a start to research, and you can also check with the DS board here on OH to find one. Hopefully you don't need to go so far as a revision, but if anyone can fix your sleeve with a minor tweak to solve you problem rather than a major revision, it would be one of these guys.

The other reason to find a DS guy is that the DS is a much better treatment for bile reflux - the gastric bypass is predisposed to bile reflux, (much like the VSG is predisposed to acid reflux) so it's not something you really want to get into if you already suffer from it.

Good luck in getting around this problem,

I had a hiatel fixed with surgery. Around 4 years out I developed a very large hiatel hernia again and was unable to keep solid food down. (I was also having gallbladder attacks during this). Like you, I had a CT and barium swallow. I did have the hiatel hernia fixed the second time while they removed the gallbladder. I did not convert to bypass- really wanted to avoid that if at all possible. Interestingly, my surgeon said if I did convert it really wouldn't help to lose additional weight, although I was concered about losing too much since I was at goal. Anyway, I am not sure I made the right choice. I am once again mildly symptomatic similar to another hernia. Only time will tell, but I might have a conversion in my future anyway. I am sorry you are going through this and I hope all goes well for you.

Oh no, I'm sorry to hear that. Hope it all works out. I've been scheduled for hernia repair and sleeve resection (bring sleeve back down to where it should be) on May 8th. Hope this will be all I need. The thought of a full bypass scares me for some reason. If the bile reflux doesn't fix it's self the revision is still an option in the future. Best of luck!!