revision due to mechanical problem

Does anyone know how difficult it is to have a revision done due to a mechanical problem, such as the lower part of the pouch becoming to large. If a revision were to be done what options are there?

I'm assuming you have a RNY.   I know some people revise to a DS.  One issue has to do with how you will pay for the procedure -  self pay or insurance?  for insurance purposes the reason the pouch is too large becomes important.  if its determined to be solely behaviorial insurance probably won't pay.  I had a revision from an old VBG (1987) to a RNY due to mechanical failure - the staple line had ruptured and I had no restriction - also the band had eroded into my stomach lining... After a small hassle, [they said no at first and I had to appeal but won at the first level review]  my insurance, a BCBS HMO did pay for it.

On these boards, I know some people have had the Rose Procedure, which [I think] deals with this issue but at least from these boards, many people don't feel it works very well .

Best wishes,

Rhonda

I had RNY in 2004 and had an EGD in August which diagnosed a dilated anastomosis.  The surgeon calls it a mechanical failure related to the sutures used in 2004 and says that the insurance will pay.  I am awaiting pre-authorization but have scheduled my revision for 11/24.  I am having the Band over Bypass.  It will be the Realize Band.  I am told the band is less invasive to DS and more effective than ROSE as well as easier to get covered.   Here in NJ the ROSE is $11,000-$12,000. so I will take all the help I can get from insurance for the band.  Plus the band is fully adjustable whereas ROSE is not.  AND band addresses issues I have been having with recurrent hypoglycemia from hyperinsulinemia and early dumping (due to dilated anastomosis).

Blessings,
Kar

 Hello,
There are Many indications for revision of a RNY operation to other procedures. I am an advocate of RNY to DS only as  for all patients.
Weight regain, mechanical problems marginal ulcers or nutritional deficiencies.

Dr. K....

I was wondering if I might ask you a question regarding Pancreatitis...Have you seen patients with this illness and does it seem to tie into RNY? I possibly have this. If I have another pain attack the Dr. wants me to have lab work so they can check my Lipase levels and I was just wondering if it could be caused from the RNY Surgery...or the ERNY Surgery I just had in May...

I read where one of the causes of Pancreatitis can be surgery...plus several other causes such as high Triglicerides...

Thank you.

Janie

Hello Janie,
Yes I have seen pancreatitis with patient who have had RNY operation. 
There are many causes for pancreatitis. High lipids can cause it. Gallstones, Alcohol may also cause this. The mechanical reason may be how the RNY limb is connected to the stomach pouch. If the limb is retrogastric, retrocolic (behind the stomach and colon) then it could sit on the pancreas, and depending on the length of it, it can cause pressure on the pancreas and cause pancreatitis.

Hope this help
Ara

This helps immensely...The Surgeon I'am seeing here in Utah has only been performing the RNY for about 5 years...and still learning I think...My RNY was performed in 1989 and was revised from a stapling that opened. Immediately following my RNY actually about 2 months after I began suffering from pain which centered in the abdomen and radiated to the back, I would often vomit but eventually the pain would subside. But this only happened 4 or 5 times a year...

I saw many Dr.'s in Bakersfield, CA where I lived at the time (I have since moved to Utah) and none of them could ever find anything wrong with me...I somewhat felt like I was losing my mind and that they didn't believe me. Soon after I received surgery this past May for a hernia and bowel obstruction and a ERNY or Distal I once again but much more often began experiencing this pain again...It is horrible when you have an attack but it never last very long...Do you have any suggestions for this? I would sure love to come and meet you...I have heard glorious things about you and your revisions to DS...I had really wanted to go that direction but couldn't get an insurance company to see it my way...

Also, when I had the Revision to RNY they removed my gall bladder and they told me it was just in time as their were several stones that were just beginning to move into the duct...Do you think it possible that a stone was actually in the duct and they missed it...Could it be their all these years without causing more trouble? Just a thought...

Janie