RNY revision, or Lap band?

Hello,

I haven't been here in a while. 4 or so years I guess. I'm sure I'm like a large amoutn of others who have had the RNY done, and have lost, and started to regain weight.

So, therein lies my question. Am I able to have a Band done after already having RNY done 5 years ago? Are there any other alternatives? How does insurance work with this?

FYI, I am 29 years old this week, and was at a top weight of 519 pounds. My bottom out point was about 3 years ago at 275 or so. Currently, I am quickly creeping back up, and am at 335 ish.

I have had a hernia, stoma stretch, and gull baldder removed since the initial RNY.

I am starting to develop sleep apnea again, and my BP is creeping up. I havej occasional rashes under where my belly lies from the previous weight loss.

Thanks!

 It sounds like what you need is an actual CONVERSION to the DS.   Go check out the DS forum and ask them.    They can tell you about DS doctors in your area, but only the surgeon (and one who actually does the DS) can tell you if you are a candidate.   Just don't trust any doc who doesn't perform the DS surgery.   They will turn you off to it, or tell you it is "impossible" to revise from the RNY to the DS when that is not true.   There is a doctor who just started posting on this forum who does this surgery (among others).   Maybe you can ask him - or maybe he will answer you if he happens to read this post of yours.  

There are metabolic issues with SMO people which the RNY doesn't completely address, but many chose it because it was the only option available to them at the time or because they didn't know about all of their options.   This is why research is so important.

Here are two research papers which may be of help to you - they go into the various revisions to the RNY and the successes and failures of each type:

www.obesityhelp.com/forums/revision/3886215/Everyone-should- read-this-Revision-Procedures-for-Failed/


and 

www.obesityhelp.com/forums/revision/3886208/Great-article-on -RNY-revisions-from-Bariatric-Journal/

On March 25, 2009 at 1:05 PM Pacific Time, JCincinnati wrote: Hello,

I haven't been here in a while. 4 or so years I guess. I'm sure I'm like a large amoutn of others who have had the RNY done, and have lost, and started to regain weight.

So, therein lies my question. Am I able to have a Band done after already having RNY done 5 years ago? Are there any other alternatives? How does insurance work with this?

FYI, I am 29 years old this week, and was at a top weight of 519 pounds. My bottom out point was about 3 years ago at 275 or so. Currently, I am quickly creeping back up, and am at 335 ish.

I have had a hernia, stoma stretch, and gull baldder removed since the initial RNY.

I am starting to develop sleep apnea again, and my BP is creeping up. I havej occasional rashes under where my belly lies from the previous weight loss.

Thanks! I'll give you my opinion...I did not want the surgical risks with a revision (I realize there are risks in every surgery) so I chose to have a band placed over old bypass...my weight loss is slow, but it is just what I need to let my head catch up with my body.  I am very pleased so far with my choice.  I go for my 4th fill this afternoon.  You really have to choose the revision that fits into your life and one that you can live with.

The good news is that there are many options from which to choose.

Good Luck!

 I will tell you what I know.  Personally I am going the other way around band to bypass.  However, my husband had a bypass in 1999, did the same as you and had a band over his bypass in 2005.  He went from 518->321->346 go the band 4 years ago and is at 236 for the last year and a half.

It worked great for hima and we know 3 others that have had success.  Now for the bad, we also know 2 who are not doing well (in their eyse).  Weightloss is very slow and they really haven't learned to use the tool.  You can eat around your band.  Soft foods, most junk foods, etc. go through fine.  If you do not learn the lifestyle of protein first, no junk food, especially no drinking with your food (you will PB) it will fail you.

So, although it is a successful surgery for the most part and many are successful.  There are, with all WLS, a downside if you do not comply with the lifestyle change.

I really hope this helps.

Putting the lapband over the bypass is possible, but given that you have a lot to loose and have already failed once, I strongly recommend you to research all options before making a decision - lapband over bypass, DS and ERNY. Of these, the DS is the most complicated one, but also the one that gives the best results. In my opinion, with your weight loss/regain history nd considering how much you have to loose, you`re a bad candidate for the lapband over bypass because you`ve most likely damaged your metabolism by dieting (any WLS that includes a restrictive part is like a long time of starvation/diet  for the body). Just eating less won`t help much if your body is super-effective and clinging to every calorie. Additionally, you`d still have to stay on a very low-fat/low-carb diet because the lapband only gives restriction and not calorie malabsorbation back. Another point is that the lapband can be easily outeaten and will only limit the amount of healthy food (dense protein + veggies), while sweets and carbs go through easily. You can find much more information about the DS and the RNY to DS revision on the DS board.

Come visit us on the DS forum.  There are many who post there that have had successful RNY to DS revisions.          

Red

http://www.obesityhelp.com/forums/DS/a,messageboard/board_id ,5357/

I hope you'll come over to the DS forum and learn more about it. We have many people posting there who have been revised to DS after either rny or lap band or vbg. It is complex surgery and you will need a surgeon experienced not just with the DS but with revisions to the DS. But it is the most effective wls available, and while you have improved your situation quite a bit with the rny, you still have a lot of weight that you probably want to get rid of permanently. The DS is your best hope for accomplishing this.

    Come on over! Feel free to ask questions, or just read what others have to say. There is no better way to learn what living with an operaiton is like than from the people who already live with it every day.

Larra

Going by your posted wls history and high bmi, I think you would be smart to look into a revision to the DS personally even though I love my band.

Given your history I agree, DS.  That's the one I would seriously research.

Given your high starting BMI - and the "metabolic stubborness" your body has surely aquired since regaining from your band - you are statistically less likely to have long-term, durable, weight loss from a RNY, let alone as a revision procedure. As a general rule, BPD/DS (or simply "DS") offers your best shot of never needing another operation. Read the column to the left about revisions to DS to start. The difference in results between a RNY and a band - long-term - are actually not that much different, at least when a revision procedure is concerned.

John D Husted, MD