Scheduled for Lap-Band over RNY Revision! Now I have Q's!
"Band over RNY is the most effective treatment for RNY revision!"
Please provide a citation -- not someone's profile -- for your statement.
While you are looking for one, here are a couple to consider:
Surg Obes Relat Dis. 2007 Nov-Dec;3(6):611-8. Epub 2007 Oct 23.
Duodenal switch is a safe operation for patients who have failed other bariatric operations.
Keshishian A, Zahriya K, Hartoonian T, Ayagian C.Department of Surgery, Delano Regional Medical Center, 1205 Garces Highway, Delano, CA 93215, USA. [email protected]
BACKGROUND: The incidence of morbid obesity and its surgical treatment have been increasing over the last few years. With this increase, there has been a rise in the number of patients who have had less than desirable outcome after bariatric operations. We perform the duodenal switch (DS) in patients for whom other weight loss surgical procedures have failed, because of inadequate weight loss, weight regain or significant complications, such as solid intolerance or dumping syndrome. METHOD: From November 1999 to March 2004, 46 revisional surgeries were performed at our institution. The data was prospectively collected and reviewed, based on a number of parameters. Operative details, perioperative morbidity, and results are reported. RESULTS: 46 patients had their original bariatric surgical operation revised to DS. This resulted in complete resolution of their presenting complaints. The %EWL was 69% at the time of publication, with a mean lapsed time of 30 months. We had no mortality. Anastomotic lea****urred in 4 patients, 2 in our first 8 patients. We also noted that the majority of the patients were not aware of all the surgical procedures available to them at the time of their original operation. CONCLUSION: In patients in whom gastroplasty, gastric bypass or both have failed to provide adequate weight loss, or worse have resulted in complications, DS can be performed as a safe revisional operation. The revision of other failed bariatric operations to DS results in both weight loss and resolution of the complications.
Julie,
Does Mish still even come to this forum? I have sent her a few private messages over the past year and I never heard anything back from her. Also, her profile has not been updated in at least a year. If you know her can you get her to post on the forum. Many people would love to hear her experience and how things are going. Thanks
Read Dr. Schlesinger's ABC's of revision. The High amount of risk for conversion from RNY to DS is very high. To convert from RNY to DS is a very complicated surgery.
Are you willing to take the high risk. I am looking into the ERNY from RNY because of these risks. I am not a lap-band candiate because of esophageal dysmotility and it would cause me so many more complications. Have a consult with a good revision surgeon.
Riiiiggghhhtt. Listen to a surgeon who doesn't/can't do the DS when he disses it. Uh huh.
WIth esophageal dysmotility, why are you keeping a pouch, rather than getting a more accomodating sleeve, along with the switch to maintain the weight loss. Oh, that's right -- you're talking to a doctor who doesn't do the switch. Good luck with that.
Diana,
Your wrong, Dr. Schlesinger does do the switch, and he doesn't diss it. If your looking at my original surgeon, No she doesn't do revisions at all, except for lap-bands over RNY and doesn't really even want to do that. This is why I am seeking out a different surgeon to do the revision. Anytime you mess witht he stomach after it has been operated on before, you risk having high probability of a leak. I had a very dear friend who died from a sleeve, so none of these surgeries are without risk. The esophageal dysmotility has nothing to do with the surgery, it is a swallowing disorder, I had before my original surgery. If I had a band I would probably choke to death, I didn't realize this until Dr. Schlesinger told me that I wasn't even a candidate for a lap band over my RNY. Why would I want to do that and develop more complications.
My take is why have such a higher risk surgery when, I don't need to and will get the same comparable weight loss with the ERNY. I am not dissing the DS, people just need to do what makes them most comfortable with themselves and their surgeons.
We are all adults here and we shouldn't be dissing people opinions, just because you are a DS advocate. People are intelligent enough to do their research and make up their own minds.
Saying you do the switch to get patients in the door, only to give some excuse why the DS isn't for YOU (which we call "bait-and-don't-switch) and actually DOING the switch are two separate things. I don't believe I have "met" a SINGLE DS patient of Schlesinger on this or any of the other DS boards I am a member of. I seriously doubt he has the experience to be a DS revision surgeon, if he rarely if ever does virgin DSs.
"Anytime you mess witht he stomach after it has been operated on before, you risk having high probability of a leak."
What does this mean? 90% probability? Or 4%, as compared to 1% for virgin sleeving (I'm making the numbers up just to make a point, because I don't know what they are and don't have time to look them up right now)? It is baseless and meaningless statements like this that give inexperienced pre-ops completely biased and misleading "information." You should be more careful.
You may get the same comparable weight loss with ERNY -- but not the same results. ERNY (AKA distal RNY) has a signficantly higher rate of malnutrition than the DS. You get the negatives of malabsorption without the benefit of being able to eat more normally and in larger quantities. Worst of both worlds, IMHO.
Diana
I was just wondering how much you know so much / so little about Dr Schlesinger ? have you had a consult with him? are you condidering some type of revision surgery? Has your weightloss be so stellar that your at goal?
I am not sure why your posting on the revision board - please dont think I am on the attack- I am just reading and trying to figure this all out.
I looked at d.s. - just was not an option for me .. As most people we have our own Idea's of what we want and what we get can be so differant due to medical and personal issue's. I dont feel the need to SLAM anyone for their choices !!!
In the end we have to be comfortable with what we choose to have done. have confidence in the Dr we choose to operate and re-arrange our digestive system. and make the commitment to be compliant. the dedication to maintain healthy habits and follwo up faithfully on medical tests.
I'm here because the misinformation about the DS that was being posted was brought to my attention. You have a problem with my posting here?
I looked at what Schlesinger posted and it is not accurate. I also have been a very active member of several DS support sites for nearly 6 years, and I've NEVER met any DS patients of his. I think that gives me a right to comment.
I'm not slamming anyone for their choices -- I'm correcting misinformation about the DS. If someone slams me in the process, however, I sometime**** back. If I'm in the mood.
I don't know why the DS wasn't an option for you -- nor do I care or have any right to know. However, I just hope the reason isn't because your non-DS surgeon gave you incorrect information, and that you don't end up regretting your choice down the road.
