3rd Bariatric Procedure - HELP!

Hi All,

I had Gastric Bypass in 2000. Over time, my pouch stretched and I was never full. As a result, I had a band placed over the bypass in 2008. I didn't lose weight with the band, but it helped me maintain it. The problem was that the band adjustment could never get right and I ended up with pneumonia twice. Band removed in 2015. Since I've gained 100 lbs. Looking to have a pouch revision.

Has anyone done a 3rd surgery?

Do you think a physician would approve it?

Thanks,

The main question is will your insurance pay for a revision. As long as you qualify based on NIH guidelines I am sure you can find a surgeon who can do a revision. Since you have had RNY, the next option for a revision is a DS. Have you checked with your insurance to see if it will cover revision?

My insurance will cover a revision, but I'm still nervous that they may find a loophole because it will be my third surgery. I believe I cannot go from a bypass to a DS. I'd have to have a revision to the pouch size.

Thank you!

Usually, you can go this route for a revision, but weight loss is less than it would be with your primary surgery.

• Transoral Outlet Reduction (TORe) (difficult to locate a surgeon in certain areas and may not be covered by insurance)
• Sclerotherapy to shrink stoma/Stomaphyx/Apollo Overstitch (these are ones that aren't done by all surgeons and is not covered by insurance)
• Addition of a Lap-Band (this is not an option since you already have it)
• Lengthen the Roux limb (may only provide a small percentage of excess weight loss 20% - 30%)
• Conversion to Duodenal Switch

I would suggest consulting with a surgeon on what the best approach is, they may have an option that would work for you, but you will have to be sure to ask if ANY procedure they suggest is covered by insurance as some, like the first two above, are cash only procedures for both the surgeon and hospital fees.

I did have a revision of my pouch and I lost about 48 lbs more after that which is about 20% they told me was possible, so weight loss was much different than with the original procedure.

This is very helpful! I have an appointment tomorrow and will research these items.

Good luck! I am hoping you get helpful information. Keep us updated!!

You can go from an RNY to a DS, but it is a complex procedure that few surgeons can do, though I have seen a few come through our support group over the years, and a couple were third timers - lapband to RNY to DS.

Where are you located? DS surgeons are relatively few and far between, and those that can do this revision are fewer still. Ask around on the DS board here, but off the top of my head, I know that Rabkin and Keshishian in Calif do them, along with Roslin in NYC, and Greenbaum in NJ. I believe that someone at Duke has been doing them, Kemmeter in MI has done some, and possibly someone in SLC.

You will likely have to travel for it but it is likely the best shot at getting meaningful weightloss under the cir****tances.

I'm in the CT/NYC area. I will research these drs. I didn't know this was possible!

Here is Dr. Roslin's profile, so you can read about his experience with the DS and read reviews by his patients who have had the DS.

https://www.obesityhelp.com/profiles/bariatric-surgeon/dr-mitchell-s-roslin/

I had a Sadi DS with Dr Roslin in Nov 2014. I lost 150lbs and don't have any regain issues no matter how much I eat. The guy is a rock star surgeon so I highly recommend him.

fyi - I'm also in CT/nyc area but would gladly travel a long distance for an expert of his caliber.