I have seen a number of people on these forums who have gone through Dr. Zare and he seems to be well regarded, though I have no personal experience with him; I am not aware of him doing the DS, though he may now be doing the newer SIPS/SADI/Loop DS which is a somewhat different animal. My above comments still apply regarding possible RNY revision vs. sleeve repair or DS.

As above, I wouldn't want to go into something like this without an alternate opinion or two. You often get into the situation where Dr. 1 says that Plan A surgery is tricky in your case so I would go with Plan B; Dr. 2 may say that Plan A is no problem, we do that all the time, or he may say the same as Dr. 1, that Plan B is the better choice in your case, which makes things easier and more comfortable for you on a decision (or he may advocate Plan C - which gives you more options to consider, etc.) But it all gives us a better idea of what can really be done in our specific case and not just reading what has been done for others in similar, or not so similar cir****tances.

There are several guys that I could suggest for a second opinion, all of whom come out of the DS world. Drs. John Rabkin, Greg Jossert or Paul Cirangle are in different practices, but all up in SF proper, and could give a good view on the viability of repairing your sleeve and/or revising it to a DS; Rabkin I am most familiar with as he did my VSG and I know that he does quite a few complex surgeries such as the RNY to DS revision and liver transplants, so he wouldn't be intimidated by a sleeve repair that might be a bit more complicated than usual. While they are all primarily DS/VSG docs, I don't think any of them would hesitate to tell you that the RNY is the best approach if that were the case - they are all perfectly capable of doing that even if it isn't their preferred procedure.

On the regain side of your problem, I have seen many over the years in our support groups who have overcome upwards of 30 lb with little problem - it takes a few months but is "do-able" much like a normal person. 40-50+ lb is more dicey, with some being able to recover that while others need some revision. If only the sleeve is redone, or is revised to an RNY, you can probably figure on losing 20 lb from the surgery itself (basically what one would expect from having to go through all the pre/post op diet restrictions again) with the rest being more individual effort. The DS is somewhat more powerful than that, but may still take some work on your side, but its regain resistance is better, which is really its strong suit.

Hello,

Yes, the sleeve helped me lose roughly 90 lbs, bringing me within 10 lbs of a good and healthy weight, but my regain - even though I am still careful of what I eat - has been about 40 lbs in the last couple of years. I'm back in an unhealthy weight range, and now with added complications. This is why I said the sleeve failed me.

:)

why do you say your sleeve has failed you since it is still"nice and trim."

I'm sorry that you are having these problems, but it is good that you are finding things out. Who did the checking on you (presumably an endoscopy) - a general gastroenterologist or bariatric surgeon that you consulted? Where are you hearing that you don't have enough stomach to repair the hernia? This is one of those maybe you do, maybe you don't things, and it depends both upon your particular condition, and the surgeon's experience and skills. The classic hiatal hernia repair for normal people is a Nissan fundoplication, and you right in that since much of our fundus has been removed for the sleeve, there may or may not be enough left to do a viable Nissan. Some surgeons can do it, while others can't.

The ulcers, and whatever other problems in your stomach and esophagus are often a consequence of the sleeve, whether in general or yours specifically. Many surgeons simply go for an RNY revision when faced with this, sometimes because it is the best approach in a particular case, sometimes because it is the best that they know how to do (while others may be able to correct the sleeve.) Simply changing to a DS won't do much for the problem a the DS uses your existing sleeve; a resleeve may or may not be done when doing this revision depending what the existing sleeve needs (but sounds like it would be appropriate in your case.) The DS would be most appropriate in correcting your regain problem and helping to maintain things the way they should be (assuming that it is appropriate for your other problems.

Who is the surgeon that you are working with (if you are), as there are a couple of good ones in the Bay area to handle this type of problem? In general, I am a big fan of second and even third opinions, particularly for revisions, as the causes for their need are more varied than for our original WLS, which means there can be a wider variety of possible solutions for the problem(s) and varied opinions on which is the best approach based upon different experiences that each surgeon brings to the table.

Good luck in getting some answers!

How can I get back on track with my goals if I've failed to try for 2 months? I've lost motivation and I don't eat according to my plan.