Revision of gastric bypass
I am considering a revision of my bypass because I think my pouch has stretched a lot. Does anyone have suggestions on what I should do, who I should see, or has anyone out there had it done. My original surgery was in 2002. I went from 260+ down to 125 and now back to 161. What meets the requirement for a revision?
Thanks a whole bunch!!!
Thanks a whole bunch!!!
I had my original surgery July 2001. I had my bypass revision July 2008. I was burping all the time. I had a barium swallow done and my pouch was 500cc. My original surgery was done lap and the original pouch was made too large. Because of it's size I had developed severe ulcers. I had a extremely experienced surgeon do my revision. You want someone who is very experienced because there will be a lot of scar tissue to work around. If your original surgery was LAP like mine it will be easier.
It is so important to make sure the surgeon is experienced in revisions. He cut away the ulcered part of my pouch and made me a new one with a new stoma. I could say I am just like I was in 2001 but I can tell my pouch is smaller than the first time.
I had my surgery because of the burping and ulcers. My insurance did not cover it because of an exclusion in the policy I had to pay cash. I lost 30 pounds in 6 weeks. I was a size 24 when I had my original surgery. I got down to a size 8. When I had my revision I was a size 12+, I am six weeks out and I just put on a size 8 again.
If you have a medical reason, reflux, burping, ulcers, etc. that should be reason for revision. Weight was not the issue for me to get a revision.
It is so important to make sure the surgeon is experienced in revisions. He cut away the ulcered part of my pouch and made me a new one with a new stoma. I could say I am just like I was in 2001 but I can tell my pouch is smaller than the first time.
I had my surgery because of the burping and ulcers. My insurance did not cover it because of an exclusion in the policy I had to pay cash. I lost 30 pounds in 6 weeks. I was a size 24 when I had my original surgery. I got down to a size 8. When I had my revision I was a size 12+, I am six weeks out and I just put on a size 8 again.
If you have a medical reason, reflux, burping, ulcers, etc. that should be reason for revision. Weight was not the issue for me to get a revision.
Hi Kdsmith
After reading your post I wondering why you developed ulcers as a result of a larger pouch ?My pouch is large also,and I have bad reflux for which I take omeprozole,also have a lot of burping as well ,but thats usually after eating ,is that when you get the burping ? after eating ? My reflux is very bad if I dont take medication with severe pains in my chest and pain when eating,
I am in the UK but they are now getting very reluctant to give me a revision ,and wanting me to diet off the excess 70lbs ,
I did have reflux BEFORE the op ,but it has def got worse since with a sliding hiatus hernia also .
Susie x
After reading your post I wondering why you developed ulcers as a result of a larger pouch ?My pouch is large also,and I have bad reflux for which I take omeprozole,also have a lot of burping as well ,but thats usually after eating ,is that when you get the burping ? after eating ? My reflux is very bad if I dont take medication with severe pains in my chest and pain when eating,
I am in the UK but they are now getting very reluctant to give me a revision ,and wanting me to diet off the excess 70lbs ,
I did have reflux BEFORE the op ,but it has def got worse since with a sliding hiatus hernia also .
Susie x
I am not sure why but the Surgeon told me if your pouch is enlarged you WILL develope ulcers. I burped all the time. Mostly air and more often when I had not eaten in a while.
My insurance would not cover anything that had to do with weight loss surgery. I do believe that you have a real medical reason to have a revision. I had all the usually test but my Surgeon said he was surprised at how bad my ulcer was. They even sent in several samples to test for cancer. He could not believe that I was not in severe pain all the time. The nerves were cut during my first surgery. He cut the bad pouch out and made me a new one from the left over. I got a new stoma. Basically just like my original surgery but I can tell the difference in the amount I can eat early out.
I am so glad I did this. I had gotten up to 192 lbs. I had my surgery July 3rd and today I wore a size pair 8 capri all day long and felt beautiful. I have had no problem taking off the extra weight fast.
Your medical argument is that taking the omeprozole is only covering up a severe problem. I am busy this week because we are having our family this weekend for a big party. I would be happy to help you write a letter to your insurance company and go into more detail about what type experience the Surgeon needs to be able to perform the proceedure. I was lucky to have one that actually wrote the medical book for the different weight loss procedures.
Don't give up. I am an Insurance Agent myself (property) the insurance companies want you to give up. If you do, you could very well be shortening your life span.
My insurance would not cover anything that had to do with weight loss surgery. I do believe that you have a real medical reason to have a revision. I had all the usually test but my Surgeon said he was surprised at how bad my ulcer was. They even sent in several samples to test for cancer. He could not believe that I was not in severe pain all the time. The nerves were cut during my first surgery. He cut the bad pouch out and made me a new one from the left over. I got a new stoma. Basically just like my original surgery but I can tell the difference in the amount I can eat early out.
I am so glad I did this. I had gotten up to 192 lbs. I had my surgery July 3rd and today I wore a size pair 8 capri all day long and felt beautiful. I have had no problem taking off the extra weight fast.
Your medical argument is that taking the omeprozole is only covering up a severe problem. I am busy this week because we are having our family this weekend for a big party. I would be happy to help you write a letter to your insurance company and go into more detail about what type experience the Surgeon needs to be able to perform the proceedure. I was lucky to have one that actually wrote the medical book for the different weight loss procedures.
Don't give up. I am an Insurance Agent myself (property) the insurance companies want you to give up. If you do, you could very well be shortening your life span.
mew6495
on 8/20/08 10:09 am - MI
on 8/20/08 10:09 am - MI
I too am in the process of a revision. I had RNY in 2001 and have gained back over 50 lbs. Have you had a upper GI or endoscopy done? These tests will tell you what you need to know about the condition of your pouch. As far as what meets the requirement for a revision, this can vary depending on what insurance you have. I would suggest calling them and inquiring what criteria you have to meet in order to qualify for a revision. Some insurance companies require that you have a BMI over 40 or 35 with co-morbidities. Have you started with you PCP? Maybe he would be willing to help you with the process.
I know how frustrating it is to see the lbs coming back on. I think sometimes we fail to remember that the wls was meant as a tool to aide with the loss. For myself it became so easy for me to take the loss for granted and then it became just as devastating to watch it reappear. Good luck on your research. And remember don't ever think that you failed the wls. There could very well be a reason for your gain. Perhaps this type of surgery was not the right type for you.
I know how frustrating it is to see the lbs coming back on. I think sometimes we fail to remember that the wls was meant as a tool to aide with the loss. For myself it became so easy for me to take the loss for granted and then it became just as devastating to watch it reappear. Good luck on your research. And remember don't ever think that you failed the wls. There could very well be a reason for your gain. Perhaps this type of surgery was not the right type for you.
Good for you on your statement to remember it isn't always ones fault if there is weight gain. I have just started seeking revision after an open r n y in 2002. There were extenuating cir****tances that stopped me from loosing after I lost 95lbs. I maintained that loss at least for the last 5 yrs but recently I have gained back 45 lbs.My original Dr does not do revisions and when I spoke to a different Dr in this state he responded by saying it is extremely dangerous and he doesn't think it would benefit me. He hadn't done that many if any and I feel he was too inexperienced.
I can't accept that as final and have just gotten an appointment with a bariatric center but I have to go all the way to Michigan because they are in my insurance network.
I am very nervous they will find some reason not to help me also. Wish me luck!
I would love to hear from anyone about their experience and successes or issues after having a revision. I need all the information I can get.
mew6495
on 8/21/08 10:35 am - MI
on 8/21/08 10:35 am - MI
Hello My_Time,
What place in Michigan are you going to? I am from Michigan and could not find a place that had the experience I was looking for in revisions that is why I am going to AZ to Dr. S. I researched the many types of revisions and for me I decided on the ERNY. I had considered the DS also. This was very appealing. For me I did not want them retaking down my pouch because from what I understand this is one of the things that make a revision risk sky rocket. But I also do not suffer from dumping or eating problems so this made it a little easier for my decision. Also from my research, I found that it is the shorter common channel that helps keep off the long term weight loss. So I figured you get the long term results with out so much risk. But like others have said, everyone is different and what is right for one may not be the ideal procedure for the next. Do your research, decide personally what you want for your self and what best suits your lifestyle and go for it. Good luck to you. And remember just because a professional has the letters Dr. in their title doesn't mean they know what is best for you. After all they are only human too and are subject to placing their beliefs on their own opinions like the rest of us.
What place in Michigan are you going to? I am from Michigan and could not find a place that had the experience I was looking for in revisions that is why I am going to AZ to Dr. S. I researched the many types of revisions and for me I decided on the ERNY. I had considered the DS also. This was very appealing. For me I did not want them retaking down my pouch because from what I understand this is one of the things that make a revision risk sky rocket. But I also do not suffer from dumping or eating problems so this made it a little easier for my decision. Also from my research, I found that it is the shorter common channel that helps keep off the long term weight loss. So I figured you get the long term results with out so much risk. But like others have said, everyone is different and what is right for one may not be the ideal procedure for the next. Do your research, decide personally what you want for your self and what best suits your lifestyle and go for it. Good luck to you. And remember just because a professional has the letters Dr. in their title doesn't mean they know what is best for you. After all they are only human too and are subject to placing their beliefs on their own opinions like the rest of us.
Hi mew6495, thanks for your input. I have been trying to do my research but as you know it is time consuming and there are so many resources. I have not heard of the ERNY. Can you tell me where to find info on it and what does it stand for? I am scheduled to go to the Barix Center in Ypsilanty and the Dr's name is Steven Polowski (sp?). Have you heard of them? They are in my insurance network, Aetna
mew6495
on 8/28/08 10:17 am - MI
on 8/28/08 10:17 am - MI
Hi My_Time, Boy do I know how much time it takes to do research! I have spent many hours on the web looking for info.
ERNY is "extended RNY". There are 3 types of RNY, Proximal, Distal and Extended. Proximal leaves your common channel with about 150 cm length, Distal is between 100 and 150 and Extended gives you a common channel of about 50 to 100 cm. The lower you have the less absorption you have.
The shorter common channel in the ERNY is about the same as what the DSers get. This is what gives them the better long term success. Look up Dr. Schlesinger on this site. He did a wonderful series of articles on the ABC's of WLS. He explains in detail information about wls surgery types. He prefers to do the ERNY over the DS for revisions due to the risk of taking down the pouch and reconstructing.
I think I have answered the rest of your questions in the e-mail I sent. When do you go to the Barix Center?
ERNY is "extended RNY". There are 3 types of RNY, Proximal, Distal and Extended. Proximal leaves your common channel with about 150 cm length, Distal is between 100 and 150 and Extended gives you a common channel of about 50 to 100 cm. The lower you have the less absorption you have.
The shorter common channel in the ERNY is about the same as what the DSers get. This is what gives them the better long term success. Look up Dr. Schlesinger on this site. He did a wonderful series of articles on the ABC's of WLS. He explains in detail information about wls surgery types. He prefers to do the ERNY over the DS for revisions due to the risk of taking down the pouch and reconstructing.
I think I have answered the rest of your questions in the e-mail I sent. When do you go to the Barix Center?
Hi, Thanks for the info. I was so glad when I was referred to this site by the Baris Clinic. I have an appointment for 12/19 and will be traveling from Maine. I have contact Dr. Schlesinger's office and am waiting for a reply form them a well because frankly I am afraid I will be turned down so am hedging my bet. Also, I see Dr. S has more experience doing revisions.
My next research will be as to what do I tell them to cause them to accept me for the revision. I am so desparate I have considered going to Mexico and that is not out of the question yet.
Thanks for the reply. Any encouragement is greatly need. 
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