Gastro-Gastric Fistula Repair

Hi...I had a VBG (stomach stapling) back in 2000.  I recently found out that I have 2 fistulas where the staple line has ruptured and I have gained back all the weight I lost.  I have been declined for a revision to my original surgery because the risks outweigh the benefits for me, because I don't have diabetes or sleep apnea!  Anyway, does anyone out there know if it's possible to just repair the fistula's to get my stomach back to the way it was?  I'm desperate, I don't know what to do.  Thanks.

The VBG was a horrible, horrible procedure. It ended up being torture for so many that had it. That's why it isn't done any more.

The people I know that had it revised to RNY, and are very happy. Maybe think about revising, rather than fixing something that's highly flawed.

Hi, thanks for you're reply but as I stated I was declined for a revision yesterday because the risks outweigh the benefits for me.  There's very limited options for revision here in Alberta.  Had I known at the time the ****ty successful rate of the surgery I had I certainly would have opted for a different one.  But back in 2000 it was very common.  So anyway, having the fistula's repaired is the next best option for me.  Aside from going down to Mexico to have the revision done.  

I know you were denied, but I would keep pursuing it. You have some very serious complications, and more are apt to appear down the road. I'm not sure if they are denying mostly based on cost, but they should come to the conclusion that keeping your VBG going is going to cost them a lot more in the long run than revising to RNY. And it's going to be end up riskier for you, health-wise, than revising would be, as well.

I haven't seen Rocky around today. She had a VBG back in the 1980s, and suffered horribly. She can offer more direct advice than I can. I'll have her look for you.

You've not posted alot of info for us to go on, but I would talk to another surgeon about your options. I would consider looking for someone who has been doing these surgeries for >10 years.

Also, is there some reason why a revision is viewed as very risky for you, or is this what your insurer says to everyone? What can you do to change the risk/reward analysis - could you do anything to lessen the risks of surgery - lose weight, lower blood pressure - I'm not suggesting those in particular, just trying to find a way to change the risk/reward analysis in your favor.  Also, it's hard to imagine that you gained an appreciable amount of weight back and are not having any side effects.

It seems like you know that you need to do something - it sounds like you are investigating what is best for you!

Hi Sharon,

When I had my first surgery I was 210 lbs, it was a VBG.  I lost 70 labs in total and was at 133 in 2007.  In 2010 I started gaining the weight back, today I am 205.  I had a scope done and it was determined that I have 2 gastro-gastric fistula's.  I've been in the Edmonton Bariatric Revision Clinics program since last May.  They have been doing tests and monitoring my eating and exercising.  On Friday I met with the surgeon and he asked a couple questions about past surgeries, weight loss, etc.  I don't have diabetes yet or sleep apnea, but I am feeling the effects of the weight gain.  Bad knees, bad back, constant heartburn, pain with eating, shortness of breath not to mention the complete loss of self confidence.  I have completely become a shut in.  I very rarely go out anymore and never make eye contact with anyone.  I just want to be invisible.  I get angry at my husband when he stares at me.  Although he thinks I'm beautiful, I feel completely embarrassed.  The surgeon said the risk to doing a revision to the RNY was something about when they connect the intestine to the new small pouch.  I didn't understand exactly what the risk in that would be.  But since that was the risk and I wasn't going to be fixing a problem like diabetes or sleep apnea, he felt it wasn't worth it for me.  I hope that helps you understand my cir****tance.  I feel the only option I have left is to go to Mexico for a revision. I thought about trying to find someone who could repair the fistulas but I'm not sure if that's the right thing to do or not.

Dawn

I had VBG back in 1986 an suffered with severe reflux for 25 years. That should be enough of a problem for revision surgery to be approved.  I ended up with Barrett's Esophagus and have to be very proactive to make sure none of the tumors (7 of them) they removed come back cancerous.  The fistulas are a mechanical failure and also should be enough of a problem to warrant a revision.  I was told if I did nothing about it I would have esophageal cancer in a few years.  Reflux is SERIOUS STUFF!

Keep fighting for the revision.  Get second and third opinions if you have to.  I was refused coverage multiple times.  I just kept bugging people and making calls.  Every time I had a gastric issue, I was at the doctor for documentation.  They finally realized that I wasn't going to give up. or go away and approved me.

I had my revision 5 years ago.  I got to 15 pounds below my goal weight by 9 months out  and have been maintaining  to within 5 pounds for over 4 years.  You deserve to be healthy.  Don't give up!

....also... I saw 6 specialists *****fused to help me.  I was referred to Mayo clinic in Rochester Mn, where I met Dr Sarr.  He was the ONLY surgeon willing to even look at me.  I had terrible scar tissue and the surgeon said there was a risk to the revision, but I was willing to take that risk rather than being miserable and facing a death from cancer.   I had a few complications after surgery, but it literally gave me my life back.

Thank you for your message. It gives me hope. Where did you have your revision done?  I'm in Alberta. It is covered under our provincial health coverage however the surgeon said he wouldn't do it for me. I'm just not sure if there are other surgeons in Alberta that would be willing. I'm looking into it. So happy you made it beyond your goal weight. That's awesome!