What are the risks of a revision

Hi everyone,
I am new to this site.. I am on a waiting list for a consult with Dr Pop at Barix.  I had my original stapling done 23 years ago. It was great for the first few years, then the weight started creeping back on.
Many years ago I had an upper GI done, only to show that there wasn't any signs of the by-pass there. GREAT!!.  Now I'm wanting a RNY revision.
Any help in what to expect would be appreciated.  eg Testing to be done, Hospital stay, complications. etc.

Thanks so much everyone,  I'm so ready for my next journey..
Charlene

For the stomach stapling 23 years ago there shouldn't be any bypassed intestine.  Stomach stapling is a whole different world from bypass.

In the 70s and 80s they were doing a procedure where they would staple off about a 5oz pouch  in the fundus of the stomach and that was it.  People were sent home with no instructions and no support.  They would overeat and bust out the staples thus.. gaining weight.

One of the problems I suspect you will have is that at that time they would use a mesh material around your stomach.  You will need to get your OR report to verify if they used this mesh.  If they did this might cut your choices for revision as a staple line may not be possible for a sleeve, RNY, or DS.  Your stomach tissue grows around this mesh and later (today) a staple line would be very difficult to do and hold an extremely high risk for a leak.  Most people with the old stomach stapling can only revise to an adjustable band IF the mesh was used.  It was used a majority of the time way back when.

Before you can know the risks and complications you have to know exactly what surgery type you had and if they used this mesh.  Then you can know what revision choices you have and go from there.

Thanks for the info...
I don't remember the mesh part, not saying that it wasn't used, I just don't remember,  I do know that a pouch was made and a band was around the esophagus... I don't know how to get ahold
of the surgical records, My surgeon passed away a couple of years ago.  Would the hospital hold records that far back???
I might give them a call in the morning.

They really weren't explaining the mesh to anyone because it was just another OR supply.  It wasn't thought to be a big deal at the time.  And it wasn't, it's only an issue now for revision purposes.

I would try to get the records from the hospital.  They probably have them.

If you can't get the medical records another option is to go to surgery hoping for a sleeve/RNY/whatever but if they find the mesh then know you'll be getting an adjustable band.

If you lost well with restriction alone and only regained after you lost restriction I'd look at a sleeve.  If you did not do well and struggled for every pound and never got to goal I'd look at restriction and malabsorption.

I never really hit goal.. I started at 350 and got to about 205,, then gradually went upwards from there.. When I got to that point, I had to have my Gallbladder out.. one of the common side effects back then.. after that I went back up gradually, now I'm up, not to my original weight, but up about 80lbs.. and fighting like crazy to keep around there...
Its funny because after I've read other peoples posts, I'm wondering if I still have something there.. I'm not a big eater more of a grazer..I sneeze when I'm full, and I can't eat alot of sugar or I'll get ill.  I never put any of this down to my previous surgery until I joined OH... and yet the scope showed that there was nothing there.. hummmm I don't know.. Its all so confusing.

Maybe restriction alone just isn't for you and you need malabsorption.

First thing you need to do is see if you have the mesh around your stomach.  THEN you can start looking at revision types.

A sneeze when you are full is a soft stop, we all have them to some degree and we have them before surgery we just never recognized what it was.  People who are banded and lose their band still recognize their soft and hard stops after their band is gone.

If we knew about these soft and hard stops before surgery we might not have gotten so big to begin with.  Hard telling.

you have been very helpful,,
Thanks so much.. :)

HI there- I worked in Medical Records for a couple of years at out Hospital... they are only required to keep your records for 7 years.....however many keep them for a long long time. These days records are scanned......however many years ago they were microfilmed... I saw some records from the 60's.

Try the hospital..... and if they don't have them... contact someone that may have your doctor's records.. they had to do something with them.

Just to clarify that many past VBGers in Toronto and Ontario had the mylar drain put in and I know personally many of them revised no problem to RNY's, DS and Lap-Bands.    I have one too that is basically just useless and causes no effect.

Mind you there is a tiny chance of those old drains causing an erosion but very rare.  (My band surgeon just dealt with one recently that was from an old VBG.)

 It sounds like you have had the old stomach stapling with a non-adjustable gastric band put on there.    You will need to be examined and tested, like MidwesternGirl says, in order to determine if you have had some mesh put in there.  

If you have had the mesh, your options for revision may be more limited than if you don't.  The mesh sometimes becomes imbedded within your tissues and is impossible to remove safely.   There may be some doctors who can remove it, but you should probably ask on the DS forum.    They know a lot about revisions on there.

From your description of your WLS experience, it appears as though you probably will need a malabsorptive component to be successful with WLS.    There are two options available to you.  

You can look into the ERNY which stands for Extended RNY (bypass surgery).   This shortens your common channel so that you will malabsorb some of the calories that you consume.   You will also malabsorb vitamins, minerals and protein - so supplementation will be a lifelong necessity.  From what I have read on this OH revisions board, the ERNY will not give you what you need to lose 150 lbs again.   (It might work if you only had 50-80 lbs to lose and needed to be opened up anyway to fix other internal problems.)

For that  degree of weight loss, you would be best off with the DS (Duodenal Switch), which provides not only a good amount of malabsorption, but a good deal of new restriction as well.   Your pouch stomach would be reconstructed into a "sleeve" stomach and by doing so, the surgeon would cut away the greater curvature of the stomach where Grehlin, the hunger hormone is produced.   The reduction of this hormone is an important component in the synergistic way the the DS surgery works.   Your hunger would be reduced, so you won't want to eat as much.  Your stomach capacity would be reduced, so you can't eat as much.   And, your intestinal common channel would be reduced, so that whatever you did eat would not be fully absorbed into your body.  

If you post on the DS forum, I'm sure someone there would be able to guide you to a doctor who does this type of revision.   You will not know if you are a candidate for it until a DS revision doctor checks you out.  

A caveat  to look out for  - there are a lot of doctors in the U.S. who say that they do every kind of revision and they do not.   They say it just to get you in the door and then they use their medical expertise, status and lingo to "convince" the patient that they should get one of the operations that that particular surgeon performs.   It happens every day all over this country.   

Just so you know, I do not believe that DS is currently being performed in the Barix clinics anywhere in the U.S.   They are RNY factories, so if you go there, be aware that they will probably recommend the RNY or the ERNY - and from what I have been reading on OH and elsewhere, the RNY probably will not work the way you want it to in the long term.   You may have to go out of state or out of the country to get the most effective surgery for your situation.

You should also be aware that WLS surgery the second time around is a slower-going process and you will take longer to drop the excess weight than if you had a "virgin" surgery.