VSG to DS Revision Questions

Hi Everyone!

I was sleeved June 2011 and still haven't made it to goal after 3 years.    I am now looking into a DS revision and have a few questions -- hoping any of you DS'rs can help answer. 

1.  Was the revision Open or Laparoscopic?  How long were you in the hospital?

2.  How much time did you take off from work?  Could a desk job person go back sooner than a physical job person?

3.  Any experience with Dr. Rabkin in SF? Pacific Laparoscopy?

4.  Anyone with BCBS - Illinois have issues getting approved for DS Revision?

Thanks in advance for your feedback!

We are seeing new people wanting/needing revision from sleeve to DS all the time. You are not alone. some people do great with the sleeve, but its benefits are limited and insufficient for many people.

I can't speak from personal revision experience, but I can say that Pacific Laparoscopy is an excellent practice and you won't go wrong with Dr. Rabkin.

Larra

Hi Jfab,

Seems to be more and more sleevers wanting to revise to DS these days. I revised from sleeve to DS after living with just the sleeve for four years. The sleeve did help me lose weight, just not enough,  and then I eventually started gaining weight back. I wish I had had the DS to begin with, but hindsight is always 20/20.

I will try to answer a few of your questions:

1. My revision was laparoscopic, but I was told it could be converted to open if needed once I was in surgery.

2. I planned to take 6 weeks off work as that is how long I get salary continuation for, and I thought that would be a good amount of time to recover. I ended up out of work for 7 months. Long story, I developed infectious necrotizing pancreatitis while in the hospital recovering from DS. This is a very rare complication of DS. I have only heard of one other person having this problem, so don't let that scare you. We are all so individual in our healing times, but I would start with whatever amount of time your surgeon reccommends for your particular situation. Many DS'rs state that after surgery, they are generally fatigued very easily, and also trying to get used to the new plumbing, so they really need the time off. That is not to say that I have not heard of some going back to sedentary type jobs within a few weeks.

3. No personal experience with Dr. Rabkin, but he is surely one of the very best, so you would be in excellent care.

4. I did not have BCBS, I had Aetna, and they recovered my revision on my first request. I would suggest calling BCBS and finding out where you can see a copy of their guidelines of necessary criteria for revisional bariatric surgery. I called my insurance, was directed to an online source for their policy, and made sure I met every criteria on the policy. I did not leave this up to my surgeons office.  Meaning, for example, I knew that they required the 6 month medically supervised diet, and I knew exactly what they expected the doctor to write in each note at each visit for this supervised diet. I made sure this was all done correctly, so that my insurance had no excuse to deny me. It worked.

The revision from VSG to DS has been very successful for me. I lost from 270 to 140 with my revision. I tried really hard to make the sleeve work for me, but it just wasn't enough. I work really hard at making the DS work for me, and it has worked well!  I do get at least 150 grams of protein a day, keep carbs low, and take all my supplements, and monitor my labs closely. I have heard of other people who the revision has not worked so well for. I'm not really sure why it works for some, and not for others. There are so many variables at play. Also, some revisioners are resleeved, I was not. This may also play a role in success for some.

I wish you the best of luck in your quest for answers. In the end, it really is a personal decision. I had no guarantees that it would work, but I could not continue to live my life in the body I was in so I took a leap of faith.

I have been researching revision for awhile. I had a gastric in 2009. My original weight was 287 prior to the surgery, my lowest weight was 195, now I am back up to 240.  I never lost the adequate weight for my height. I find myself hungry all the time. I went to one doctor about the revision, he wasted my time and money to tell me my insurance want cover the procedure. He never went through the process of contacting them. I was stuck with a bill. I would like to talk more to you to find out what I need to do to get a revision. I have been researching for over a year to find information on revision and if my insurance covered it. I am looking forward to talking to you.

1.  Was the revision Open or Laparoscopic?  How long were you in the hospital?

Laparoscopic. I was in for two and half days and two nights. 

2.  How much time did you take off from work?  Could a desk job person go back sooner than a physical job person?

I took not quite three weeks. I have a very physical job as a traveling nurse. I was driving and seeing patients all over the place after three weeks of surgery. A desk job would be cake but it really depends on the person and their tolerance for pain. I have a high pain tolerance. 

3.  Any experience with Dr. Rabkin in SF? Pacific Laparoscopy?

nope. 

4.  Anyone with BCBS - Illinois have issues getting approved for DS Revision?

I had BCBS of NC and at first they approved me but when I switched surgeons I had to fight for it. However, my surgeon called them and they immediately approved it. 

I wish you luck!

I'm not a revision but throwing in my exp with surgery.

Lap in 2011

4-5day stay but of friends I know who had it done they were in about 3 days.  No issues were found with me but I did have issues trying to keep fluids down.  I left the hospital with the drains and were removed about a week later.

The clinic would only approve me for 3 weeks off work but I feel it took me longer for recovery (as most major surgery might- but again I was not like the majority with recouperating.)  I have a desk job.  Physical job would probably have been tougher because internal swelling was rough enough that I could not lay on my tummy for probably 2 months.

Not in IL nor did I have Rabkin but BCBS ins in NY.  I reviewed their policies for what they would allow- ruling out disorders, etc.  You may want to find a copy of their policy (probably online).  Revision surgery may be different though?  Correct me if I am wrong- with sleeve to DS you are really just getting step 2 of the DS completed? 

Feel free to PM me if you have any other questions!  I will do my best to help

P.S.  I would be interested in hearing your reasons for revision.  I have a friend thinking VSG would suit her but I know little of what to share, if any, problems she may encounter.  She has PCOS if that helps.

Hi, I had a VSG in Aug 09 in MX and only lost about 40-50lbs with heavy exercising. At about 6mo out had a swallow study that show my sleeve was shaped like an hourglass which is thought to be why IT failed me.  After gain back all the weight plus some I revised to DS on 12Mar.

1.  Was the revision Open or Laparoscopic?  How long were you in the hospital?

I was done lap without complication. I was in the hospital 4day but was well enough on the 3rd day but I asked to stay an extra day cause I had not had a BM and was a little afraid.

2.  How much time did you take off from work?  Could a desk job person go back sooner than a physical job person?

I went back at 2weeks. I have a desk job with lots of flexability. I did fine but I was fatigued. I too naps at lunch time. 

3.  Any experience with Dr. Rabkin in SF? Pacific Laparoscopy?

no experience but he is highly regarded on this board. His patients seem to do well with minimal complications and he take on some of the tougher cases.

4.  Anyone with BCBS - Illinois have issues getting approved for DS Revision?

no experience with this insurance.