Is a DS revision from VSG better for my Barrett's esop a better option than RNY?

I've had a a failed lap bad that was just horrible, then I was switched to the vsg 3 years ago I lost about 65 lbs then regained over 20 now. In all this my acid reflux has been awful with a recent emergency endoscopy at the hospital for not being able to swallow. I was then diagnosed with Barrett's. I will see my surgeon next weds but he's thinking of resleeving me. I wonder if the DS will solve my issues with non sufficient weightloss and this just horrible acid problem? I take to Prevacid in a day at times then throughout the that day I'll chew on 6-8 of Roland's then have another type of acid reducer at night.  I'm just miserable. I don't reaaly like the RNY but if there's no other reasonable option well then I'll do it. Any suggestions? Thank you

I think it would be helpful for you to have a consult with a surgeon who does the DS before making this decision, as well as with your present surgeon. A surgeon who doesn't do the DS isn't going to recommend it even if it's your best option.

I would think a re-sleeve would not be a good option because tightening your sleeve may worsen your reflux. If you were to have a DS, it could be done with a loose sleeve (i.e. the one you already have) and the metabolic changes and malabsorption should help you lose weight. It could be done without any work on your already worked on stomach. On the other hand, gastric bypass usually does help people with reflux - but you don't want gastric bypass (and I don't blame you!). So a consult with a surgeon experienced with the DS, who hopefully has encountered this issue before, would really help sort out your options.

Given where you live, your best bets are either Dr. John Rabkin of Pacific laparoscopy in San Francisco, or Dr. Ara Keshishian in Glendale. Both are very well regarded DS surgeons and both do a lot of revisions.

Larra

Larra, thank you very much! I will look at the surgeons you mentioned. The other concern is that I've had to pay a separate fee for my surgeon to revise wls method of about 2thousand dls apart from my insurance deductible. Is this a normal practice with wls surgeons? I know that if I have another revision I'll be paying this hefty price for his service of doing another surgery 😾

Some surgeons do have a "program fee" or a fee by some other name that is not covered by insurance. They do this because the payments from insurance companies are crappy for the time and skill that goes into bariatric surgery, esp revisions, which are almost always more challenging than virgin operations. I don't like it, but I understand why they do it, and I do feel they should be adequately and appropriate compensated for their work.

Each surgeon has his or her own fees, so you would need to ask. If you are going to pay a fee, as well as your deductible and all, you should absolutely make sure you are having the right operation with the right surgeon.

Larra

Thanx Larra,

i agree, my surgeon is very competent! His experience is worth it. 

Who is your surgeon, and why on Earth is he thinking of re-Sleeving someone who's already got real acid problems??? tightening your Sleeve may 'cure' your weight-loss problems, but you can pretty much bet it's also going to make your acid problems worse, not better.

Is there any chance you have a haital hernia? They're a very common cause of acid reflux, and repairing them usually cures the reflux. That would be the first thing I'd be looking at. Get the acid under control, then go to a full Ds without a re-Sleeve.

Hi there!  I had horrible GERD for 20 years.  Could not have coffee or OJ because I would pay for days.  I would take Nexum in the morning, Tums through out the day and at night some Pepcid.  I went to see my surgeon for a sleeve and after much discussion, he recommended RNY because he could take care of my two major health issues (GERD and 100lbs over weight) and advised me a sleeve would make my GERD even worse.  I didn't want to do RNY but after realizing if I didn't I would have to go through two operations for a sleeve and GERD repair - I decided to go with the RNY in December 2014.  Well looking back now - it was the best choice I have ever made.  I had a large Hiatle Hernia the doctor repaired at the time of the RNY.  I am down 57lbs so far and now have absolutely no heartburn or GERD symptoms and I don't have to take any prescription meds.  Not always easy - but well worth the work I am putting in for a lifetime of health.   

What does acid reflux feel like?

Hi there Apple,

well my Gerd, feels like hot oil coming up my throat and sometimes you taste it and it's bitter. I've tried to help myself by not eating and drinking as day it's there.sometimes it gets so bad after a meal that I have to vomit in order to get relief. I also have learned to chew my food very thoroughly and eat slowly.  Sometimes it gets so bad after a meal that I have to vomit in order to get relief. I also have learned to chew my food very thoroughly and eat slowly.  This is no fun to tell you !

The DS won't get rid of the sleeved stomach, and the sleeve is not so good for someone with Barrett's esophagus.  To relieve the reflux, the RNY is your best bet.  I'd really question my surgeon about how re-sleeving will help the reflux and prevent further erosion of your esophagus!