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 Going from lapband to RNY is almost a virgin surgery (unless there's a lot of scar tissue left over from the lapband).   You may also want to consider the sleeve (VSG), if the lapband didn't work for you because you had problems with it.   The sleeve has the same long term success rate as the RNY, with the added benefit that it is easily revisable to the DS, which seems to be the surgery that every revisioner wants.   The sleeve surgery removes the greater curvature of the stomach which is where the majority of Grehlin (the hunger hormone) is produced, and this contributes to the surgery's success rate.   With the RNY and the lapband, the body is still churning out Grehlin 24/7!!

Some people do well with restriction alone, but some do need the extra benefit of malabsorption.  There are lots of RNY doctors in California, but only a few who do the DS (which is the surgery that has the highest long term success rate).   Any doctor who does the DS can also do the sleeve because the sleeve is the first half of the DS.  

I think Dr. Rabkin is in Northern California, but you'd be best served to ask this same question on the DS board and see what they say.     In the meanwhile, take a look at these two research papers which go into the various types of revision surgeries and the successes and failures of each - you will see that the RNY needs revision for a certain proportion of patients:

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/

I have been reading these forums for two years now and have seen people get a lapband, then convert to the RNY, then get lapband over their RNY and still not achieve the success they were hoping for.   Then they want the DS, but it is difficult to get because only a handful of surgeons in the US have the skill to convert the RNY pouch back into a working stomach and then cut away the sleeve.   Once you cut your stomach into the RNY pouch, you severely limit the types of revision you can have, and the articles I have provided above are clear in which revisions are the most successful.  So, think long and hard about what you really want and think about whether or not you will be able to change your eating and lifestyle habits or achieve success with the RNY.    Those that have been successful with it (long term) are the ones who have been able to COMPLETELY change their lifestyle.   Others gain a good portion or all of their weight back.  The DS, however, is more "forgiving" for those who truly have eating disorders and/or metabolic issues.   It is a stronger "tool" for success.

Good luck. 

I agree with Stacysmom except for one thing, and thats the benefit of doing the sleeve knowing you can convert later to DS if you want/need to.

There is evidence that the intestinal part of the DS and the sleeve work together from the start, increasing your weight loss, but if you have sleeve first and wait say a year that this effect reduces - if you think the DS is right for you, get it all at once if you can.

 I agree completely with PekinSal.   The sleeve and the intestinal portion of the DS work synergistically (restriction + malabsorption at the same time)  for the greatest amount of weight loss during that 18 month "window".    I usually mention that when I talk about the sleeve.   Thanks, PekinSal for mentioning that fact.    It's important for people to know.   

I applaud you for doing research on BOTH the RNY and the DS. You will find tons of surgeons ready and willing to perform the RNY on you, but not so many able to do the DS. It's a trickier surgery. But assuming you don't have any erosion issues with your band, the surgery you're looking at isn't as risky as, say an RNY to DS revision, because your tummy hasn't yet been cut into.

The person posting above is right - the difference between the RNY and the DS is notable, and I urge you to look very closely at the differences. Do NOT ask an RNY surgeon about the DS... you'll either get no information or misinformation. Do your own research and then look for a surgeon.

If you find the DS is the right surgery for you, then don't compromise on anything else, regardless of how close the RNY surgeon is. This is a decision you'll live with for the rest of your life.

I had the choice of staying in my hometown and having a VBG to RNY revision, or traveling to another state to get a VBG to DS revision. I'm traveling from Seattle to NJ, because I feel so strongly that the DS is my best chance for success.

Do your research. Choose your surgery. THEN select your surgeon.

And the best of luck to you, regardless of which surgery you decide upon.

Kathy

One issue to think long and hard about is why the band failed.  Was it that the band caused problems for you?  Was it a situation where you lost well until the band caused problems or was it just too hard to watch what you were eating?

If you can do it with restriction alone the sleeve is a great choice.  If you feel you need restriction and malabsorption then DS.

Hi MSXYX:

If you want another excellent revision surgeon to DS Dr. Ara Keshishian is one to check out. He is in Delano, California and also does surgery I believe 1 day a week in Verdugo Hills, CA.

Also, Dr. Kevin Higa is another Revision to DS Surgeon. The 2 Dr.'s I have mentioned as well as Dr. Husted in Kentucky are excellent surgeons...But quite honestly any Dr. who does a DS should successfully be able to take you from a Lap Band to DS....It's not quite as tricky as RNY to DS.

Good Luck...

Hope you find what your looking for.

 

JRolfson

 

Dr. Dennis Smith in Marietta Georgia does that.