Revision or Mistake?

Hello friends. I have returned back to these forums because I'm facing a second surgery. I had gastric bypass surgery 10 years ago and start gaining weight back after about 18 months. Since that time I've had countless problems that are all related to the weight-loss surgery. In addition to a very bad case of GERD I now have vitamin deficiencies, iron deficiencies which I have to have iron infusions every month.  Things have been pretty rough for a while now, as I've been still having trouble eating, and trouble sleeping because I'm throwing up in my sleep. On a typical night I wake up several times with gastric juices coming from my mouth and my nose and I'm choking. I've gone from doctor to doctor trying to figure out what's wrong and it was only recently diagnosed that when they did the gastric bypass the staples that separated my pouch from the rest of the stomach had come loose. I'm wondering if that's happened to anyone else because I've never heard of such a thing?  It's really unbearable and I have to do something about it. I went to another doctorWho said that he would need to go back in and fix it. Again I know a lot of people who have had the weight-loss surgery and this is the first time I've heard of this! I guess what I'm trying to figure out is is this something that is common Or was there possibly a mistake made? Any input you all could give me would be greatly appreciated. #Not again!

Sounds like you have what's called a staple-line disruption. They used to be pretty common, back when surgeons just stitched a couple lines of staples between the new pouch and the remnant stomach. These days, almost all surgeons transect the pouch---meaning they cut it completely away from the remnant stomach and oversew the staples. When this happens, you're back to having a full-sized stomach. Weight gain is pretty common, because you can eat a LOT more than you could when your pouch was intact. This may also be related to your acid reflux, but I haven't read much about that. Did he mention that you might have a hiatal hernia? They're notorious for causing reflux.

As for vitamin deficiencies---can you tell us what vitamins and supplements you've been taking? How recently did you have a complete set of labs done? What did they show? I suspect your surgeon either gave you no vitamin advice, or inadequate vitamin advice. After the RNY/gastric bypass, you need to be taking several different vitamins every single day, and getting labs run at least annually.

Iron deficiency is VERY common after the RNY, because iron is mostly absorbed in the duodenum, the uppermost part of the small intestine. This gets bypassed in the RNY, so it's almost impossible to get all the iron your need orally.

Now---you said you started gaining weight after about 18 months. How's your weight right now? How much weight do you hope to lose if you get a revision? If I found myself in your shoes, I'd research the VSG/Sleeve and the DS/duodenal switch BEFORE I had surgery to repair my RNY. You might find that one of these procedure would suit you better, and if so now's the time to change while your stomach is relatively intact.

I understand your issues and everytime I read a post like this I cant help but keep thinking of the statement my surgeons nurse told me when I was inquiring about a revision at 3 years post op. She said don't do any revisions only because they only cause "more" complications. More scar tissues. Which cause more problems.I left it at that. I will deal with my regain on my own. To this day it is a 5 lb regain. I feel for you