Revision gastric bypass advice

i am 20 years post op roux en y GB.  I lost 181 lbs within the first 15 months and would redo it all again.   Going from 300+ lbs to 119 changed my life.   As time has passed my stomach (pouch) seems to hold more and I don't feel full as quickly as I did before.   I have gained 41 lbs and want a revision.  I have had several of the sclerotherapy 4 times and it didn't seem to help.   My RYGB was done before laparoscopic was introduced, so I was cut from the top of my breast bone down to my belly button.    I have since had a tummy tuck, breast implants, butt/thigh lift, lipo, complete face lift, and arm revision.   I go through surgery very well and am good patient, wanting a GB revision but don't know my options.   My surgeon is outstanding but has since retired.    What would doctors recommend?  

Hi

For more replies post this on Revision Weight Loss Surgery Forum and Roux-en-Y Gastric Bypass Surgery Forum (RNY)

Also, enter your zip code in the upper right hand corner and then drill down the list of surgeons that do revisions.  Check to see when their next free seminar is being held and you can attend and ask questions at the meeting.

It really comes down to your medical history and health now. You may find  you will need to meet and get an exam from a surgeon to determine what is best for you.

Good Luck

The first thing you need to do is see if your insurance will cover a second bariatric surgery.  Most of them won't unless you have a mechanical failure or life-threatening complications.   I'm not sure a surgeon would do a revision with only a 41 pound regain if there is not a mechanical failure.

Everyone's pouch holds more over time.  It grows to about the size of a soda can, but not as big as the pre-surgery stomach, which is the size of a football.  Have you had an endoscopy to see if your pouch is functioning as it's supposed to?  If your pouch is still working, losing 41 pounds is doable by changing what and how much you eat.  Try eliminating any simple carbs ( like potatoes, rice, pasta, bread, sugar, crackers, etc.)  and focus on dense proteins and veggies.  Limit fruit to one serving per day.  

Eat 6 very small meals (200 to 300 calories) every 3 or 4 hours.  If you are drinking with your meals, STOP!  Drinking with meals allows us to eat more food at one sitting, causing regain.  Don't drin****il 30 minutes after a meal.  Drinking with meals and eating too many processed, simple carbs are the most common reason for re-gain. 

Good luck!

According to your profile, your BMI is 31. You may have a hard time finding a surgeon to do any kind of surgical revision. Even if you do, if you do not get your eating habits under control you will most likely gain weight after a revision. Track your food. Weigh/measure your portions. 

Ditto what Ricky and Laura said.  You are going to have a hard time finding a surgeon to do a revision (OR get insurance to cover it) with a BMI that isn't at least 35.

I think you may find that if you go back to strict portion control and protein first with limited carbs, you will find that you can get the weight off.  It is easy to let portion sizes and carb consumption creep up just in 5 years or so, let alone 20!!  

Most of us who are more than 5 years out (I will be 8 years in a couple of months) find that if we eat as much as our pouches would allow, we gain weight.  you don't need to eat until you feel completely full; you only need to eat until you have had enough protein and you are satisfied (no longer actually hungry).

Lora

I agree with the others but I do think it may be worth your while to see a WLS doctor to check things out and make sure you don't have any mechanical failure.

Sometimes that is enough for the insurance company to pay.

You also have the option of paying yourself, although if you are like most people that may not be realistic.

I am sure that things have come a long way from when you had WLS and there have been a lot of advances.

When I had my revision nearly 5 years ago they told me that the surgery they did then was completely different then the surgery they did 5 years prior to that.

I can only image that same is true today.

If things do check out then the good news is that you still have a tool and you can go back to using it anytime you wish.

One of the best things my surgeons nurse said to me after I inquired about a revision, She said more surgeries cause more scar tissue therefore causing more complications. Yes Scar tissue causes more problems, I can attest to that very easily. After so many stents put in me through my groin I developed so much scar tissue in that area that it was causing me to limp. Good luck. I am trying to lose that last 20 lbs on my own.. I have maintained my 100 lb weight loss but still want that last 20 lbs off before my birthday June 28th. I am cutting out that late night eating and I am walking more everyday now that the weather is getting warmer..Wendy