How do you know if you should consider a revision?

Can anyone help me; don't even know where to start.....

I had open RNY on 5/25/04 -- so I am now more than 5 years post op....  and have been fairly well...  but within the last year ....  it seems like I am starting to regain weight...  slowly but surely... 

I went through way too much ....  and it is like nothing is working ...... 

Where do I start.

Go see your surgeon,,, IF he does All types of revisions, and you like him.

Be tested to see if there are mechanical failures

Read, and read and research all your options!

Good luck!

 I would suggesting contacting your primary care physician and asking him to order an upper GI and an endoscopy to determine the condition of your pouch and stoma.  This will also help you with your insurance approvals if a mechanical failure is found.

Then call your insurance or go on line and see what their benefits are and what criteria you have to meet.  Be very clear that it is for a revision and not a first time WLS.  Once you find out start working towards meeting their requirements while you get your testing and surgeon/revision research under way.

Do the research on types of revisions available to you and what long term effects you can live with for your own personal choice and life style.  Regardless of what you may hear there are side effects to ALL WLS revision surgeries.  You have many options.  The single most important thing is to find a qualified surgeon who has performed not just virgin wls surgeries but many, many, many revisions.  Some of your possibilities are;

1. RnY to DS.  Very good long term statistics but also one of the most complicated to perform with the take down of the pouch and reconstruct of the stomach.  There are not many surgeons qualified to do this revision but there are a few and I am sure if this type interests you after your research then post on the DS board and these folks will be willing to lend a hand.  Check out dsfacts.com

2.  RNY to ERNY.  This is where they shorten the common channel of the malabsorption aspect of your wls.  The intestinal portion is similar to the DS but the pouch is typically left untouched.

3. Band over bypass.  This provides restriction only by placing a lap band around your pouch.

4.  Stomaphyx, Scelatherapy (sp?)  and ROSE.  These add restriction back to your pouch and/or stoma resize.  These are the least invasive but to date have not shown real promising long term success.  I think there are a few here that post every once in a while but I have not seen to many long timers post.

Good luck to you on your search and your new journey!