Open surgery for a VSG to DS revision?

good evening all,

Hopefully this question is okay to post on this board. I wanted to be sure to ask this to DSers specifafly. I had my VSG done 2 years ago.

I've been researching and thinking seriously about revising to a DS. I had my consult today with Dr Rabkin in SF and my question is, that he told me right off the bat that he recommends that I get re-sleeved and revise to DS. I was expecting him to say that, however I was not expecting him to say that it must be an open procedure. Is this common? I've done a lot of research about this but I haven't seen many people say it was open. Dr Rabkin said the incision would be vertical from the bottom of my breastbone to the top of my belly button. 

If you have had this, how was the recovery? I've had open surgery on my shoulder before but the thought of that large of an incision on my belly is making me think twice. I know he is a highly regarded DS surgeon and if I do revise to DS it'll be with him, this was just a curve ball to me today. Thanks all :)

Mine was open and the recovery was no big deal.  Makes sense that he wants to see how much smaller he can make your sleeve.  As far as surgeons go, he is one of the best.

My virgiin DS was done open, and it's not a big deal at all.   My incision was glued all the way down - no sutures or staples to deal with, and it was healed in 2 weeks.

Re-sleeve is more difficult and higher risk than a virgin sleeve. It is important that the new staple line not cross over the old staple line, because this would create a small area without an adequate blood supple, which, a few days later, could lead to a leak, which is a very serious complication.

I understand your concern about the incision, but the reality is that what's important is what's done on the inside, not on the outside, and esp with revisions it has to be done just right.

Larra

Thanks for all the info. He did mention that in order for the DS to be successful for me I would need to be re-sleeved. And in order to do that the old staple line has to be completely removed and redone. He did say that it is possible to do this procedure lap, however to ensure the best chance to not have leaks or complications it should be done open. 

My concern isn't for how the incision looks. I have had multiple surgeries and have many scars, I was just concerned about the healing process with having an open procedure. It seemed to me that it would increase my recovery time by weeks, but from everyone's comments that doesn't seem to be the case. You have all calmed some of my fears and concerns :) 

hi; i had the open rny 16yrs ago and for me

it was painful but the pain depends on the person

i myself can't tolerate pain. the inside has to heal as well as the outside.

put it this way if you were able to handle the pain for your lap/sleeve;

then the open re-sleeve will be no big deal either. As for how long it took me to

be completely healed; if i remember i had about 14 days by the time they took stitches

sutures out but i still had to watched what i did like lifting, and other things. i didn't "feel"

completely healed til 6 months out then the pain inside and out was gone.

I'm revising from VSG to DS on April 11th and it will be open as well. My doctor said it is safer. 

I just had my open ds i am 4 weeks post op. The incision is healing so good. I honestly think it will heal to where it will be a very feint line. And that would be the least of ur worries.  For me recovery has been rough only because i wasnt taking my vitamins and getting water in. So make sure u do that and id say you should be fine. But i cant comment on the possible revision of ur sleeve. I dont know much about that. But good luck w.e. ur decision is. Everyone is very supportive on here. 

Dr. Rabkin did my partner's surgery and he loved him!

Hi.   I haven't posted on this forum for quite a while, and I know I'm late coming to this thread.  I just wanted to chime in.   I had a sleeve gastrectomy in 2008.  It really didn't help me much.   Just over a year later, I had the DS portion done with the intestines.

My sleeve I guess was new enough that it really didn't need to be resleeved, so "just" the intestinal part was done.  I woke up from that surgery with a mujch better, happier feeling.  Like every cell in my body just somehow KNEW I'd turned over a new leaf.

My gastric sleeve was done lap, the DS portion was done open.   It seems to me that the incision is really the least important part of the surgery.   You will be recovering from your intestines being re-routed, and that skin incision just pretty much isn't much of a factor.   I actually had a harder recovery from the sleeve.  I think the important thing is to have the surgery that your surgeon will be the most comfortable doing.   That's kind of the salient point, IMHO.

But the outcome is what makes it so magical.   I lost about a total of 30 pounds with the sleeve.   Most of that was lost during the liquid diet portions after the sleeve and before the DS.  After the DS, I lost about another 220 pounds.   I didn't lose it as fast as some of the people here - I lost about 10 pounds a month.  It was frustrating to compare myself to the people losing 10 pounds every week or so, but then I remembered that they were much younger and were able to do more exercise, etc.   We are all so individual.

Good luck and quick recovery.   I've certainly never looked back or regretted the surgery, or even having had it in two steps.   I gave the sleeve the old college try, and I'm sure you did, as well.