Revision in Winston-Salem

I have had the lap-band for ten years and feel it is time for a revision. I have had horrible reflux with the band.

I am considering the RNY or DS.

Any advice out there?

Thanks,

Kim

Like all WLS all of their pros and cons; both are malabsorptive procedures. The amount of malabsorption is one significant difference, the other is that your high piloric valve remains in tact with the DS, where it is 'bypassed' with the RNY. While these are broad generalizations, the RNY does require vitamin supplementation, but not nearly as much as the DS because with the DS, signficantly more of the intestine is removed or 'bypassed' The next big differnce is that the DS is done with a 'sleeve' that leaves the high piloric valve in tact, where the RNY creates a 'pouch' that doesn't have the high piloric valve. Patients who need to take NSAIDs often prefer to use the DS because they can safely take them, where can be dangerous for RNY patients to take NSAIDS. Another cosideration is the amount of weight you need to lose. DS is often reserved for patients with very high BMIs, so if you have a BMI over 50 your insurance is 'more likely' to approve with a DS than if it is under 50; that said, there are DS patients that started with lower BMIs. Both procedures require tight compliance to supplementaton to ensure your long term health. DS has a more significant supplemenation requirement because more of the nutrient absorbing intestines have been removed. 

Often when someone has had a lapband and is being revised, the revision is to an RNY. This occurs for a few of reasons: The RNY is considered the 'gold standard', the damage done by a lapband may make a DS sleeve difficult to acheive, and finally, getting the insurer to pay for a DS vs an RNY revision.

I hope that this has helped some. Remember that both are good, valid options, you'll just need to weigh the pros and cons of each. 

Wishing you all the best,