I am interested in the gastric sleeve procedure. I have had the Nissan Wrap procedure and then it has been taken down. Does anyone know if a doctor will do the sleeve or what other options would their be. Im in my mid fifties and my bmi is 37. I have sleep apnea high blood pressure high cholesterol and boarderline diabetic any suggestions

if you had the Missan wrap you must have GETD. A vertical sleeve can make reflux much worse.

think more than twice and very carefully before having the sleeve.

Ditto this. If I'd had GERD to the point of needing a Nissen, I'd never have considered the VSG. RNY would be the surgery to look at, IMHO.

Because you've already had some GI surgeries, I would recommend that you be VERY particular in choosing a surgeon. You'll want someone with a lot of experience doing surgeries on people who've had other GI surgeries. They can find scar tissue or other anatomical changes due to the previous surgeries, even though you had the Nissen taken down. A surgeon with a good history and record with revisions of various types can tell you if your particular case is viable.

Generally speaking, since surgeons do VSG and RNY with all sorts of erosions and damage from lap-bands and such, I wouldn't think having a previous Nissen is automatically an exclusion for WLS. But each case is different, so you'll need to be evaluated by a surgeon to know for sure.

Nobody on OH is a doctor. Your best bet is to find a surgeon in your area and make an appointment to see what his/her recommendation will be, given your medical history.

You'll also need to call your insurance company to see what surgeries, if any, they will cover in your situation.

Hi! I just met another runner. His wife died from esphogeal cancer caused by acid reflux.

So if you have problems with that...just saying...

On September 26, 2017 at 4:00 PM Pacific Time, SkinnyScientist wrote:

Hi! I just met another runner. His wife died from esphogeal cancer caused by acid reflux.

So if you have problems with that...just saying...

[MarinaGirl]: My aunt (mom's identical twin sister) died from esophageal cancer 4 weeks after being diagnosed. She had a long history of obesity and GERD.

I have GERD and Nissen fundoplication surgery has been recommended to me in the past but I chose to first lose weight with gastric bypass and am doing much much better; no more PPIs required. IMO, you should steer clear of VSG; however, talk to multiple bariatric surgeons to get their expert advice for your situation.

Just to repeat what everyone has already said... my surgeon said absolutely no to the sleeve because I had really bad acid reflux and recommended the rny. I'm really pleased with my rny and aside from the occasional tums I am totally off of gerd medications. This may not apply to you but I just wanted to let you know. Also, pick your surgeon with care. As skinnyscientist said gerd is very serious... my husband died from esophageal cancer caused by gerd. Best of luck to you. Nancy

Ditto that the RNY is the most commonly done when GERD is a problem however this is partly because most bariatric surgeons are most comfortable with the RNY and may not have much experience with complicated sleeve problems. Your best bet if you seriously prefer the sleeve is to look into surgeons who perform the duodenal switch (DS) as they overall have the most sleeve experience in the bariatric world. Further, though they generally prefer the DS or VSG over the RNY, I have found that they generally have no problem recommending the RNY in situations where it is appropriate, so if one or more of those guys recommends the RNY, that's pretty solid advice.

A rather incomplete listing of DS surgeons can be found here:

https://www.dsfacts.com/duodenal-switch-surgeons.php

but it's worth seeking them out in complicated situations like yours.

RNY Is recommended for GERD because most of the stomach is disconnected from the pouch therefore most of the juices made by the stomach don't have a path back to the esophagus therefore eliminating GERD

This is very true. It also depends upon the source of the GERD and other mitigating factors, some of which can be corrected along with the surgery. It is still a risk, as the sleeve does have some predisposition toward reflux, much like the bypass being predisposed to dumping, marginal ulcers and bile reflux (that doesn't mean that these things will happen, just that there is a bias towards them.) If one is set on getting a particular procedure and already has one of these problems as a pre-existing condition, then it is best to deal with those specialists most experienced with that procedure and in mitigating its problems. Hence the recommendation to seek out a surgeon well experienced with sleeves to give the OP the best answer to her question - which may well be a bypass (and likely is.)