ENDOSCOPY REVISION

Hi all, I just found this board. I had an endoscopy done 6 weeks ago which revealed my stoma opening is measuring at 31 cm; should be around 10 cm.  Dr. Thompson (Brigham & Women's Hospital) is recommending endoscopy surgery to close the stoma opening - I don't know if he is doing anything with my pouch. I had gastric bypass surgery March, 2004, and lost 215 lbs. I've gained back 12 lbs. and my level of hunger is painful and insatiable. Dr. Thompson says this is because what I am eating is dumping very quickly into the lower intestine because of the size of my stoma opening. Is what he is recommending a "revision" - will I lose the weight just by closing up the stoma but otherwise doing nothing to the pouch?  Can a "revision" be done endoscopically?  Thanks, I really appreciate your insight and help on this! My surgery is scheduled for 4/16. Maureen

I went to see a gastroenterologist on yesterday and was told that as they do my EGD they can make my pouch smaller and repair the stoma.  So that part of your question I know.....

My interpretation of this is that your physician is probably looking at the Rose proceedure or maybe a  stomaphyx. According to the Dr that I saw this is not a revision but simply adjusting things to make them work like they did when you first had surgery. Its an out patient  proceedure usually. A revision would be where they actually go in and surgically revise what has already been done to make it work better.(ie- RNY to DS or RNYproximal to distal, adding a lapband to an RNY. Hope this helps a little -

I agree. Revisions are normally much larger procedures than anything that can be done endoscopically. From what I can tell, the risks are much higher during revisions, the recovery is longer, the cost is higher, and the results are less than stellar. For these reasons I am looking at the Stomaphyx as a revision option. It is done endoscopically, through the mouth, so there are no abdominal incisions!!! The procedure consists of making pleats in the stomach and/or stoma to reduce the size and stop if from emptying quickly. There are no BMI requirements for this procedure so those of us who haven't gained a lot of weight back, but who are loathe to do so, can get help before things get real bad again. I have gained back 35 pounds and although I am not obese, I am steadily gaining, always hungry and back on the weight loss/weight gain rollercoaster. Psycholigically, it is devastating, disheartening, and discouraging. My weight and what I eat has once again become the central focus of my life. None of my clothes fit anymore. I can't keep the weight off and don't feel good about myself. You are lucky you have a good doctor. Endoscopic procedures like yours are designed to combat the problems of post WLS weight gain without exposing patients to more invasive and complicated surgeries. Ask your doc to reduce your pouch size if it has stretched, as well as tighten your stoma. It only takes an hour or so to do a Stomaphyx. Which procedure are you having, exactly? Good luck with it! I'd love to hear more about it. Lili

HI I am currently a Pt of Dr. Tompson also. I am/was is a study called the Restore trial  endoscopic transoral  sutureing. I can tell you to go to the revsion board and yu can find out alot about it. Dr. T  is curently doing this on non study Pt. He is/or will be doing the pouch , you should realy ask him. Maybe your pouch is not big enough.  But my stoma is 35mm very large so I know what you mean. I have gained 23 pounds since my surgery in 2004. I never maid it to goal to begin with. So I wonder how long this has been going on for me since I was never full even after 6 mo out. Hope this helps  kim

Hi Kim, and thanks for your post! It's good to actually "connect" with a patient of Dr. Thompson's. Have you had the procedure done already? If so, when, and are you happy with the results? What did he actually do via endoscopy - just reduce the stoma opening, or did you reduce the size of your pouch as well? It's very difficult to get any answers, practically impossible to talk with any of his staff.  I'm just very confused about what is going to be done. Thanks, I really appreciate your time in responding to my questions and concerns. Maureen