3rd times arevision is a charm (I hope) RNY gastric by pass revision from proximal to distal...
Dr. Ungson (not Ungston) does not do and to my knowledge has never done RNY to DS revisions. The people who are telling you this are people who have been here and on other DS sites for years. We know who the players are. He does do lap band to DS revisions and I would assume sleeve to DS revisions, but that doesn't help you.
You are right that your RNY would need to be completely reversed to convert it to a DS. You are right that this carries significant risks. However, you are wrong that an ERNY would give you "all the benefits" of a "modified DS", whatever that is. In fact, ERNY is a difficult operation to live with because you combine malabsorption of both protein and the fat soluble vitamins with no stomach regulation AND the vitamin/mineral malabsorption you already have from your RNY. There are people who make a success of it, but it requires much more diligence than either a standard RNY or a DS. You also could still have dumping, and you would still not be able to take NSAIDs. In other words, both RNY and DS have certain disadvantages and you get all of them with ERNY.
No, my DS was not a revision. I had a virgin DS over 8 years ago with Dr. Robert Rabkin, who has since retired. His younger brother, Dr. John Rabkin, continues the practice and does a lot of revisions, including RNY to DS revisions. He's far from you, but then again so is Dr. Ungson and you were considering him. Dr. Rabkin is in San Francisco. Another excellent revision surgeon is Dr. Ara Keshishian in Glendale, CA (a suburb of Los Angeles). Closer to you would be Dr. Roslin in NYC. Dr. Greenbaum in NJ does some RNY to DS revision but is very selective. I don't know if Dr. Elariny in VA does this particular type of revision - you could call his office and find out, I would think, just be very specific on any calls or emails about what your prior surgery was. Everyone seems to do revisions from lap band because there are so many lap band failures, finding someone to revise RNY to DS is much harder.
Another possibility MIGHT (I'm not sure!) be Dr. Ayoola in Denton, TX. I saw someone saying they were having a RNY to DS revision with him, so perhaps he's started doing them. Dr. Simper in Utah is another one.
You have a tough decision to make. On the one hand, there is more surgical risk with revision to DS. On the other hand, it really is a much better operation longterm than ERNY. No one here can make this decision for you.
Larra
For overseas, the only ones I would recommend are Dr. Marchesini in Brazil or Dr. Baltasar in Spain. I would absolutely not recommend anyone in Mexico for this particular revision. And even with the reputable surgeons, you need to communicate well and make sure you and the surgeon are on the same page about what surgery is going to be done and what is not.
Larra
I am struggling keeping the weight down. I had my first RNY gastric bypass in 2008 was 303lbs got to 220lbs very slowly and then after about 18 months starting going back up and returned to old eating habits and everything. In 2013 I was back up to 260lbs so got revision because my gastric pouch was 10 cm and my anastomosis was very wide. The pouch and the anastomosis were revised but and I got to 220lbs again then weight loss stopped again. Now it is back up to 260lbs the pouch is at 8 cm and anastomosis is at 25mm. My limbs are 75cm Roux loop, and the 30cm bilio-pancreatic limb. I am considering revising again to distal gastric bypass and not DS to get more malabsorption. Any advice???????
revisions sometimes are not clear cut, and I dont believe one surgery type is for all. i understand the weight gain fear, and I agree I would attempt a revision also, but I would not get an ERNY, I dont like that surgery type. I only know one person that has not has more problems with the erny than when they had the rny. I would suggest revise to a DS, you will be able to eat like a normal person with a pyloric valve. A rny to ds is for the very few surgeons. I would suggest Dr Keshashini, Dr Roslin, Dr Elinary, Dr Rabkin. I hope you find your answer soon.
Laura,
Do you know what BPD (Scorpion procedure) is, if so how does it compare to DS? ERNY? Also, what sleeve size is best and why? Do you know if anastomosis dialated considered mechanical failure for medically necessity? Have you heard much success from Denton Texas surgeon Aaybo (something like that)?
