Stomaphyx vs. other revisions
I've seen a lot of questions about this lately, so I thought I'd share what I've learned after some obsessive researching and talking to my surgeon. Everyone is different and has different needs and complications. I may offend someone with over simplifying, but it is certainly not my intent. We are here to support each other and learn. If we are reading this forum, something didn't work the first time around. All of the surgeries are tools and they can all be "tricked" to some degree if we are willing to suffer the consequences. Some of us have addictions and bad habits. Some of us had failed procedures, complications or life cir****tances that got in the way. I attended an information meeting at my surgeon's last night with some other patients who "qualify" for revision. I was shocked how little some of them knew about the details of their previous surgeries or of the consequences of drinking carbonated sodas. So, here are some basics that I think are true: There are multiple factors that contribute to the speed of weight loss for the different procedures. Calories and exercise play into it, but the mechanics of the type of surgery do too: - pouch size - the bigger it is, the more calories you can consume at a time - stoma size (gastric bypass) - the smaller it is, the longer the food stays in the pouch and the longer you feel "full" - the amount of intestine that is removed affects the percentage of calories absorbed - gastric bypass can be proximal or distal (a little ot a lot removed). DS usually results in more intestine removed, banding alone does not remove intestine. - other failures like ruptured staple lines can also cause problems Revisions can address any of these things. The pouch can be made smaller (surgically, with stomaphyx, or by banding), the stoma smaller (surgically through the abdomen or orally like schelotherapy, rose or stomphyx), more intestine removed (going proximal to distal or going from RNY to DS) . The first thing you have to do is see where the problem is. Upper GIs seem to be the best way to identify pouch size and stoma size. One of the most important things I learned is that a revision that only changes one or both of those generally will not produce rapid weight loss like the initial month right after a bypass because the malabsorption is not there like it was after the initial procedure. The body adjusts when something changes. But, if the original surgery was successful, it can be again with a little more patience and work. For some people, they may want something more. Unfiortunately, insurance seems to cover only "full revisions" where the stoma is repaired and more of the intestine removed. Because of scarring, that can be riskier than a transoral repair. Just some thoughts - please feel free to comment or correct me. I'm here to learn too. Based on what I know and my current life situation (a somehat young, healthy mom with a stretched stoma who wants to work hard at this but not take extra medical risks), I'm opting for stomaphyx. My surgeon would like to do it in September, so I'll know soon. If it doesn't help enough, there's always DS down the road. ~Shelley
