The ABC's of Revision A to Z

Kathi, Based on the information that you have provided, you would have all WLS options available to you. The decision as to which procedure would best enable you to meet your goals and desires is one that should be made by you and your surgeon. I do not have sufficient information to be able to give you a specific recommendation, but a highly malabsorptive priocedure deserves serious consideration.  All pouches should be constructed as "right sided". These pouches are less susceptible to dilitation (stretching) and are also more ammenable to NOS should "tightening" ever be indicated. GOOD LUCK! Eric Schlesinger, MD, FACS AZ Weight Loss Solutions 

 

Dr. Schlesinger, Thank you for taking the time to answer our questions.  I want you opinion on my situation.  I had RNY surgery in October 2004.  I had a starting weight of 451 lbs.  When I had my 1 year visit to the surgeon a statement the surgeon said crushed me.  At that time I was approximately 315-320 lbs.  The surgeon basically told me he was happy with my progress and that he would be totally happy if I didn't lose any additional weight.  I was shocked and saddened to have him say this.  Here I am 5'5 1/2 and STILL over 300lbs.  I truly believe at that very moment I gave up hope of my goal of being "overweight" instead of "super morbidly obese".  It has been 2 1/2 years and in that time I have lost about 20-25lbs.  I am currently at 292lbs.  At best I have lost and gained about 10lbs over and over.  I truly believe it is my time to achieve my goals.  I can say that I have not been back to my original surgeon nor have I had any blood-work done since that time (which was so wrong of me I am fully aware of that).  I recently moved to another city and have an appointment with a new surgeon to continue my follow-up and to see what my next steps should be. My question is at just this bit of information, do you think a possible revision would be in my future?  Please also note that before that I also went to the surgeon to talk about my concern that I had never had that "full" feeling that I had been expecting with no consistent feeling of being satisfied.  An Upper GI was done and I was told that things looked fine.  Any help would be greatly appreciated. Regards, Erica P.

Erica, Based on the information that you have provided, I believe that you would potentially be an excellent candidate for a revision.  I am delighted that you have sought the follow up you need and deserve. It is vital. Before considering any revision, the results of your malabsorptive panel are required. Although, I would need more information, simply based on your size and previous surgery, an ERny, the highly malabsorptive one, deserves very serious consideration. NEVER GIVE UP! Eric Schlesinger, MD, FACS AZ Weight Loss Solutions

Dr. Schlesinger,

I'd like your advice please. I'm participating in the Restore study, and I am sure I had the procedure, because it was billed incorrectly to my insurance instead of the study. In the meantime I checked into a revision, and had another bariatric surgeon perform an upper gi and small bowel series. He feels my bypass looks just fine. I have lost 20 lbs since I had the Restore procedure, but is it possible for that procedure to produce or aid me in losing another 100 lbs?

What are my revision options? The doctor mentioned a Stomaphyx, but I've not been able to get the medical coding for that to determine if my insurance will pay for it. I am eligible for some type of revision well, at least I've covered for one with my insurance. I verified that.

I started at 484, lost down to 230, and gained back about 50 lbs. Right now I'm at 261, so I'm still morbidly obese being that I'm 5'5. 

Any advice or suggestions. I reside in Fort Worth, TX.

Thank you in advance,

Nannette Bryant

 

 

 

Nanette, Congratulations on your weight loss with ReSTORE!  If, after the upper GI, your surgeon recommended the Stomaphyx procedure, this would lead me to believe that  your pouch, stoma, or both still appear dilated. No NOS (Stomaphyx, ReSTORE, ROSE, EROS) is as yet covered by insurance.  All things are possible, but a 120 lbs. weight loss from NOS is more than anyone has reported. As far as your other options are concerned, either a "Band Over" procedure or an ERny should be discussed with your surgeon. You have been given mixed messages regarding your new degree of restriction. Your weight loss says something must be working after ReSTORE. Your surgeon's recommendation of Stomaphyx says that more restriction could be beneficial. If your most recent malabsorptive panel is good, a highly malabsorptive procedure (ERny) deserves serious consideration. Don't rush into anything. Before having any further surgery, wait. Let's find out how successful you will be with the ReSTORE procedure. CLAIM THE SUCCESS YOU DESERVE! Eric Schlesinger, MD, FACS AZ Weight Loss Solutions

Thank you Dr. Schlesinger for your response. One more question,please. What is an ERny? And is that something that would be covered under insurance as a revision ? I will stick with the study for the duration of it and see what my results are.  Again, thank you. Nannette

OOps....I found my answer to what an ERny was in an earlier post !   Again thank you.

Dr. Schlesinger, I had my RNY 9/2000, with Dr. Michel Gagner @ Mount Sinai Hospital in NYC. Surgery was successful and I lost weight and stayed healthy. Now I find that I have regained thirty pounds and I am considering Stomaphyx. I am a new participant to this web site which I find to be very interesting and informative. You have answered most of my questions through other member interests. However, I do need to know the meaning of NOS, ERNY, and RESTORE. Also, what is the expected weight lost percentage for stomaphyx?     Thank you so much for sharing your knowledge with all of us.      Sincerely, Poinciana

Poinciana, NOS is the acronym for Natural Oriface Surgery. In the case of Stomaphyx, ROSE, ReSTORE, & EROS, these are procedures to "tighten" the pouch/stoma with the use of a gastroscope and the appropriate instrument "over" the scope. ERny stands for Extended Roux-en Y, the highly malabsorptive variant of the by-pass operation. Like all NOS revisions, Stomaphyx is new. My experience has been that patients can achieve a 40 to 50 lbs weight loss.  Eric Schlesinger, MD, FACS AZWeight Loss Solutions

Dr. Schlesinger, I had my Stomaphyx procedure done Monday(5/12/08) by Dr. Michel Gagner@ Mount Sinai Medical Center in Miami Beach, FL.  Everything went well. No pain, no scars. I did experience a sore throat and sore chest for one day. I am two days out of surgery and I am at home back into my routine. I was on the treadmill today for 45 minutes, no problem.  I will keep everyone posted.  I am happy,happy, happy!!!!   Poinciana